MEDICARE: DR. ENRIQUE RAFAEL ROVIRA D.M.D.

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	1223G0001X	General Practice Dentistry	DN8973	FL

General Provider Information

NPI Number	:	1750500039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ENRIQUE RAFAEL ROVIRA D.M.D.

Provider Business Mailing Address
First Line	:	5110 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8773
Country	:	US
Telephone Number	:	407-282-6380
Fax Number	:

Provider Business Practice Location Address
First Line	:	5110 CURRY FORD RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-8773
Country	:	US
Telephone Number	:	407-282-6380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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