Healthcare Provider Details

I. General information

NPI: 1467186023
Provider Name (Legal Business Name): INOUSHKA DEE MEJIAS ROVIRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

25 CARR 149 UNIT 1684
CIALES PR
00638-3680
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-662-4179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23747
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: