Provider Demographics
NPI:1831698059
Name:ROJAS, OLYS Y
Entity type:Individual
Prefix:
First Name:OLYS
Middle Name:Y
Last Name:ROJAS
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 1:11245 SW 227TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-3511
Mailing Address - Country:US
Mailing Address - Phone:786-641-0028
Mailing Address - Fax:
Practice Address - Street 1:11245 SW 227TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-3511
Practice Address - Country:US
Practice Address - Phone:786-641-0028
Practice Address - Fax:888-519-0759
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCBHCMS100972104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1043635972Medicaid