Provider Demographics
NPI:1417123209
Name:ROJAS-VIVAS, MABEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MABEL
Middle Name:P
Last Name:ROJAS-VIVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MABEL
Other - Middle Name:P
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:425 W COLONIAL DR STE 303
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6863
Mailing Address - Country:US
Mailing Address - Phone:407-956-1920
Mailing Address - Fax:689-304-0303
Practice Address - Street 1:920 N JOHN YOUNG PKWY FL 4914
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4914
Practice Address - Country:US
Practice Address - Phone:407-956-1920
Practice Address - Fax:833-450-5410
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1081208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice