Healthcare Provider Details

I. General information

NPI: 1922955277
Provider Name (Legal Business Name): SUSAN ELIZABETH ROVIRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 58
SPRINGDALE UT
84767-0058
US

IV. Provider business mailing address

PO BOX 58
SPRINGDALE UT
84767-0058
US

V. Phone/Fax

Practice location:
  • Phone: 702-373-3630
  • Fax:
Mailing address:
  • Phone: 702-373-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number370886-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: