Healthcare Provider Details

I. General information

NPI: 1619880937
Provider Name (Legal Business Name): BORIS ROJAS MORALES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9299 SW 152ND ST STE 206
PALMETTO BAY FL
33157-1776
US

IV. Provider business mailing address

9299 SW 152ND ST STE 206
PALMETTO BAY FL
33157-1776
US

V. Phone/Fax

Practice location:
  • Phone: 786-883-0339
  • Fax:
Mailing address:
  • Phone: 786-883-0339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number9538955
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: