Provider Demographics
NPI:1922346089
Name:MARILLA, ROBERTO ROJO JR (RPT)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:ROJO
Last Name:MARILLA
Suffix:JR
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 500409
Mailing Address - Street 2:1 LOWER NAVY HILL
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-0409
Mailing Address - Country:US
Mailing Address - Phone:670-234-8950
Mailing Address - Fax:670-236-8756
Practice Address - Street 1:1 LOWER NAVY HILL
Practice Address - Street 2:500409 CHALAN KANOA
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-0409
Practice Address - Country:US
Practice Address - Phone:670-234-8950
Practice Address - Fax:670-236-8756
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP0036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist