Healthcare Provider Details

I. General information

NPI: 1992906374
Provider Name (Legal Business Name): LUIS R. ROJAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PMB 304 3071 ALEJANDRINO AVE.
GUAYNABO PR
00969
US

IV. Provider business mailing address

PMB 304 3071 ALEJANDRINO AVE.
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-3200
  • Fax: 787-993-1842
Mailing address:
  • Phone: 787-708-3200
  • Fax: 787-993-1842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number3629
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: