Provider Demographics
NPI:1912540378
Name:SANTOS-ROJO, MARIA GUADALUPE (PA)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:GUADALUPE
Last Name:SANTOS-ROJO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2175 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE A-104
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-275-4415
Mailing Address - Fax:480-275-4577
Practice Address - Street 1:2175 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE A-104
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-275-4415
Practice Address - Fax:480-275-4577
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ7761363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program