Provider Demographics
NPI:1811510514
Name:ROJAS LOPEZ, NIURKA
Entity type:Individual
Prefix:MRS
First Name:NIURKA
Middle Name:
Last Name:ROJAS LOPEZ
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 1:12702 SW 184TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2503
Mailing Address - Country:US
Mailing Address - Phone:786-768-0498
Mailing Address - Fax:
Practice Address - Street 1:12702 SW 184TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2503
Practice Address - Country:US
Practice Address - Phone:786-768-0498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL530350106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician