Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | ME35393 | FL |
NPI | 1427027291 |
---|---|
Provider Name | Dr. Roberto Fojo JR. |
First Address | Hialeah, FL 33016-5534 |
Second Address | Hialeah, FL 33016-5534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 09/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
067003100 | (05) | FL |
D64249 | (02) | FL |