Basic Information
Provider Information
NPI: 1700010923
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROZAS
FirstName: ALEXANDRA
MiddleName: K.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9007
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229069007
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: LEE ST FL 1
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229080001
CountryCode: US
TelephoneNumber: 4342430630
FaxNumber: 4349821618
Other Information
ProviderEnumerationDate: 05/04/2009
LastUpdateDate: 08/11/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X0101256321VAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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