Provider Demographics
NPI:1447884739
Name:FERNANDEZ ROJAS, JOSE LUIS (APRN)
Entity type:Individual
Prefix:MR
First Name:JOSE LUIS
Middle Name:
Last Name:FERNANDEZ ROJAS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17820 NW 55TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3118
Mailing Address - Country:US
Mailing Address - Phone:786-479-8481
Mailing Address - Fax:
Practice Address - Street 1:17820 NW 55TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3118
Practice Address - Country:US
Practice Address - Phone:786-479-8481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006242363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner