Healthcare Provider Details

I. General information

NPI: 1033744420
Provider Name (Legal Business Name): JANELIE ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 TAMIAMI TRL N
NAPLES FL
34103-2853
US

IV. Provider business mailing address

6536 ILEX CIR
NAPLES FL
34109-6855
US

V. Phone/Fax

Practice location:
  • Phone: 239-351-0675
  • Fax: 239-631-5295
Mailing address:
  • Phone: 239-404-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-114023
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: