MEDICARE: GEORGE ROVITO MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME80354	FL

General Provider Information

NPI Number	:	1174984017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGE ROVITO MD PA

Provider Business Mailing Address
First Line	:	3577 NE 168ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3560
Country	:	US
Telephone Number	:	305-986-3386
Fax Number	:	305-949-1868

Provider Business Practice Location Address
First Line	:	3577 NE 168TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3560
Country	:	US
Telephone Number	:	305-986-3386
Fax Number	:	305-949-1868

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GEORGE E ROVITO
Credential	:	M.D.
Telephone Number	:	305-986-3386

Provider Enumeration Date	:	03/18/2016
Last Update Date	:	03/18/2016

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