Provider Demographics
NPI:1053519439
Name:ROHENA, JORGE ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:ALBERTO
Last Name:ROHENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:A
Other - Last Name:ROHENA SANTAELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:LOIZA VALLEY LAUREL ST.
Mailing Address - Street 2:412
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-3533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 AVE WINSTON CHURCHILL
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6651
Practice Address - Country:US
Practice Address - Phone:787-765-3954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17407208D00000X, 207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine