Healthcare Provider Details

I. General information

NPI: 1164305694
Provider Name (Legal Business Name): DANIEL ROVIRA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20937 SW 127TH CT
MIAMI FL
33177-7404
US

IV. Provider business mailing address

20937 SW 127TH CT
MIAMI FL
33177-7404
US

V. Phone/Fax

Practice location:
  • Phone: 786-315-6925
  • Fax:
Mailing address:
  • Phone: 786-315-6925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-444808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: