Healthcare Provider Details

I. General information

NPI: 1417123209
Provider Name (Legal Business Name): MABEL P ROJAS-VIVAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MABEL P ROJAS MD

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5564 E GRANT ST
ORLANDO FL
32822-1666
US

IV. Provider business mailing address

1000 NW 57TH CT STE 400
MIAMI FL
33126-3292
US

V. Phone/Fax

Practice location:
  • Phone: 321-235-6230
  • Fax: 321-235-6246
Mailing address:
  • Phone: 407-956-1920
  • Fax: 689-304-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1081
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: