Provider Demographics
NPI:1124645742
Name:ROJAS, ANGIE (NP)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:BABSON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33827-8709
Mailing Address - Country:US
Mailing Address - Phone:863-978-9808
Mailing Address - Fax:
Practice Address - Street 1:4745 OLD CANOE CREEK RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-1400
Practice Address - Country:US
Practice Address - Phone:407-818-1664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1104279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UNSUREOtherUNSURE