Provider Demographics
NPI:1427825462
Name:ROFEROS, REY PLASABAS (AGPCNP-BC)
Entity type:Individual
Prefix:MR
First Name:REY
Middle Name:PLASABAS
Last Name:ROFEROS
Suffix:
Gender:M
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14280 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-2628
Mailing Address - Country:US
Mailing Address - Phone:657-341-9383
Mailing Address - Fax:
Practice Address - Street 1:1701 SE TIFFANY AVE STE 105
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7576
Practice Address - Country:US
Practice Address - Phone:772-446-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029993363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health