Healthcare Provider Details

I. General information

NPI: 1629188503
Provider Name (Legal Business Name): JOSE ROJAS JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ENVISION PHYSICIAN SERVICES 7600 W. SUNRISE BLVD
PLANTATION FL
33322-4113
US

IV. Provider business mailing address

7600 W SUNRISE BLVD
PLANTATION FL
33322-4115
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5305
  • Fax: 954-618-4347
Mailing address:
  • Phone: 954-939-5305
  • Fax: 954-618-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME135211
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200861
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA06674900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: