Healthcare Provider Details

I. General information

NPI: 1922296581
Provider Name (Legal Business Name): ROSA ROJO RN BSN C.D.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 HARRISON ST STE 606
HOLLYWOOD FL
33020-7829
US

IV. Provider business mailing address

1930 HARRISON ST STE 606
HOLLYWOOD FL
33020-7829
US

V. Phone/Fax

Practice location:
  • Phone: 954-651-5133
  • Fax: 800-430-9814
Mailing address:
  • Phone: 954-651-5133
  • Fax: 800-430-9814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberRN2162402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: