MEDICARE: DR. VALENIE RIVERA ROIG M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	14868	PR
2	207N00000X	Dermatology Physician	ME124390	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295784957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALENIE RIVERA ROIG M.D.

Provider Business Mailing Address
First Line	:	151 SOUTHHALL LN
Second Line	:	SUITE 300
City	:	MAITLAND
State	:	FL
Zip	:	32751-7176
Country	:	US
Telephone Number	:	407-875-2080
Fax Number	:	407-650-3455

Provider Business Practice Location Address
First Line	:	14050 TOWN LOOP BLVD
Second Line	:	SUITE 203
City	:	ORLANDO
State	:	FL
Zip	:	32837-6190
Country	:	US
Telephone Number	:	407-852-6650
Fax Number	:	407-852-6035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	08/11/2015

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