Healthcare Provider Details

I. General information

NPI: 1275262602
Provider Name (Legal Business Name): ZORIMAR ROJAS FILIPPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W NEW CIRCLE RD
LEXINGTON KY
40511-1833
US

IV. Provider business mailing address

500 W NEW CIRCLE RD
LEXINGTON KY
40511-1833
US

V. Phone/Fax

Practice location:
  • Phone: 859-381-0910
  • Fax: 859-381-1271
Mailing address:
  • Phone: 859-381-0910
  • Fax: 859-381-1271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number110430
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: