Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | DO 3109 | FL |
NPI | 1083634976 |
---|---|
Provider Name | Mr. Angel J. Rojas |
First Address | Miami, FL 33135-1327 |
Second Address | Miami, FL 33135-1638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 09/07/2007 |