Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME78113 | FL |
Y | 207PP0204X | Pediatric Emergency Physician | ME78113 | FL |
N | 208000000X | Pediatrician | ME78113 | FL |
NPI | 1598713976 |
---|---|
Provider Name | Jose Rosa-Olivares |
First Address | Miami, FL 33255-7367 |
Second Address | Miami, FL 33155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
258545600 | (05) | FL |