Basic Information
| Provider Information | |||||||||
| NPI: | 1740555754 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE JESUS ROJAS | ||||||||
| FirstName: | WILFREDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | CENTRO MEDICO MENONITA CAYEY | ||||||||
| Address2: | PO BOX 373130 | ||||||||
| City: | CAYEY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00737 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | CENTRO MEDICO MENONITA CAYEY | ||||||||
| Address2: | BARRIO SECTOR LOMAS | ||||||||
| City: | CAYEY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875351001 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2012 | ||||||||
| LastUpdateDate: | 08/10/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 18974 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0214X | 18974 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | 208000000X | R2079 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.