Provider Demographics
NPI:1740916972
Name:ROJAS, JOE
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:ROJAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10893 NW 17TH ST UNIT 129
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2059
Mailing Address - Country:US
Mailing Address - Phone:786-223-1396
Mailing Address - Fax:
Practice Address - Street 1:10893 NW 17TH ST UNIT 129
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-2059
Practice Address - Country:US
Practice Address - Phone:786-223-1396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNE-45899172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty