Healthcare Provider Details

I. General information

NPI: 1356669014
Provider Name (Legal Business Name): DAVID MAGDY ROUFAIEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 JUPITER LAKES BLVD BLDG 4000, SUITE 206
JUPITER FL
33458-7191
US

IV. Provider business mailing address

210 JUPITER LAKES BLVD BLDG 4000, SUITE 206
JUPITER FL
33458-7191
US

V. Phone/Fax

Practice location:
  • Phone: 561-944-5534
  • Fax: 561-461-6121
Mailing address:
  • Phone: 561-944-5534
  • Fax: 561-461-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number274935
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME137285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: