Healthcare Provider Details

I. General information

NPI: 1922346089
Provider Name (Legal Business Name): ROBERTO ROJO MARILLA JR. RPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LOWER NAVY HILL 500409 CHALAN KANOA
SAIPAN MP
96950-0409
US

IV. Provider business mailing address

P.O. BOX 500409 1 LOWER NAVY HILL
SAIPAN MP
96950-0409
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax: 670-236-8756
Mailing address:
  • Phone: 670-234-8950
  • Fax: 670-236-8756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0036
License Number StateMP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: