Provider Demographics
NPI:1922529692
Name:ROZAS, JUSTIN II (NP)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:ROZAS
Suffix:II
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6345 ALFRED RD
Mailing Address - Street 2:
Mailing Address - City:MAURICE
Mailing Address - State:LA
Mailing Address - Zip Code:70555-4014
Mailing Address - Country:US
Mailing Address - Phone:337-322-8102
Mailing Address - Fax:
Practice Address - Street 1:2315 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4031
Practice Address - Country:US
Practice Address - Phone:337-374-7620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily