Provider Demographics
NPI:1255460317
Name:ROJAS, BORIS (MD, FAADEP)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:MD, FAADEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAN JUAN HEALTH CTR
Mailing Address - Street 2:DE DIEGO AND BALDORIOTY AVE. #150, SUITE 703
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2300
Mailing Address - Country:US
Mailing Address - Phone:787-724-5155
Mailing Address - Fax:787-724-5167
Practice Address - Street 1:SAN JUAN HEALTH CTR
Practice Address - Street 2:DE DIEGO AND BALDORIOTY AVE. #150, SUITE 703
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-2300
Practice Address - Country:US
Practice Address - Phone:787-724-5155
Practice Address - Fax:787-724-5167
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR063397OtherBLUE CROSS
PRPE2160OtherPALIC
PR9-5279Medicare ID - Type Unspecified