Healthcare Provider Details

I. General information

NPI: 1811196850
Provider Name (Legal Business Name): ROVI INTEGRAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 SW 16TH ST SUITE 122
MIAMI FL
33145-2067
US

IV. Provider business mailing address

2200 SW 16TH ST SUITE 122
MIAMI FL
33145-2067
US

V. Phone/Fax

Practice location:
  • Phone: 305-858-4700
  • Fax: 305-858-4842
Mailing address:
  • Phone: 305-858-4700
  • Fax: 305-858-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE VICTORIA
Title or Position: PRESIDENT
Credential:
Phone: 305-858-4700