Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1033785571 |
---|---|
Provider Name | Gerardo Rojas |
First Address | Hialeah, FL 33012-7193 |
Second Address | Hialeah, FL 33012-7193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2021 |
Last Update Date | 03/06/2021 |