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General NPI Number Information
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NPI Number | 1043522063
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Entity Type | Organization
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Legal Business Name | JOSE R ROVIRA MD PA
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 07/07/2010
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Provider Practice Location Address
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Address Line | 11760 SW 40 STREET SUITE 646
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City | MIAMI
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State | FL
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Zip | 33175-8101
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Country | US
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Telephone | 305-552-5354
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Fax | 305-222-8444
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Provider Business Mailing Address
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Address Line | PO BOX 565006
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City | MIAMI
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State | FL
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Zip | 33256-5006
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Country | US
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Telephone | 305-552-5354
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Fax | 305-222-8444
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE R ROVIRA
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Credential | MD
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Telephone | 305-552-5354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME25875
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License Number State | FL
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