Provider Demographics
NPI:1831734995
Name:ROJAS, LUCERO (TARGET CASE MANAGER)
Entity type:Individual
Prefix:
First Name:LUCERO
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:TARGET CASE MANAGER
Other - Prefix:MRS
Other - First Name:LUCERO
Other - Middle Name:
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:TARGET CASE MANAGER
Mailing Address - Street 1:7910 CAMINO REAL APT 308
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6711
Mailing Address - Country:US
Mailing Address - Phone:442-291-0554
Mailing Address - Fax:
Practice Address - Street 1:7910 CAMINO REAL APT 308
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-6711
Practice Address - Country:US
Practice Address - Phone:305-646-0112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL891254171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator