Provider Demographics
NPI:1679280150
Name:ROLON, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:ROLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 JAMAICA DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-4609
Mailing Address - Country:US
Mailing Address - Phone:305-244-0142
Mailing Address - Fax:
Practice Address - Street 1:4901 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3301
Practice Address - Country:US
Practice Address - Phone:305-922-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician