Provider Demographics
NPI:1922858992
Name:JOSE LUIS FERNANDEZ ROJAS APRN LLC
Entity Type:Organization
Organization Name:JOSE LUIS FERNANDEZ ROJAS APRN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-479-8481
Mailing Address - Street 1:17820 NW 55TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3118
Mailing Address - Country:US
Mailing Address - Phone:305-450-3206
Mailing Address - Fax:
Practice Address - Street 1:17820 NW 55TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3118
Practice Address - Country:US
Practice Address - Phone:786-479-8481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty