Healthcare Provider Details

I. General information

NPI: 1689878134
Provider Name (Legal Business Name): JUAN MANUEL ROJAS BALCAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 NW CORPORATE BLVD STE 105
BOCA RATON FL
33431-8554
US

IV. Provider business mailing address

1825 NW CORPORATE BLVD STE 105
BOCA RATON FL
33431-8554
US

V. Phone/Fax

Practice location:
  • Phone: 561-299-3667
  • Fax: 561-299-3670
Mailing address:
  • Phone: 561-299-3667
  • Fax: 561-299-3670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2010-01182
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2010-01182
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2010-01182
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: