Individual
KENNIE JOSE SANTIAGO ROJAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
5404 BAYWATER DR, TAMPA, FL 33615-3542
(832) 542-5871
Mailing address
5404 BAYWATER DR, TAMPA, FL 33615-3542
(832) 542-5871
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
23-400
FL
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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