Provider Demographics
NPI:1255115358
Name:ROJAS PEREZ, ELBA PAOLA
Entity type:Individual
Prefix:MS
First Name:ELBA
Middle Name:PAOLA
Last Name:ROJAS PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15250 SW 134TH PL APT 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1187
Mailing Address - Country:US
Mailing Address - Phone:786-525-8808
Mailing Address - Fax:
Practice Address - Street 1:11276 SW 232ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7505
Practice Address - Country:US
Practice Address - Phone:305-912-8399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23282502106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician