MEDICARE: DR. JANICE ROUSELLE DEFELICE D.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	1223G0001X	General Practice Dentistry	DN17618	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	:	1386702827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE ROUSELLE DEFELICE D.M.D.

Provider Business Mailing Address
First Line	:	250 180TH DR
Second Line	:	304
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-2796
Country	:	US
Telephone Number	:	305-542-6644
Fax Number	:

Provider Business Practice Location Address
First Line	:	226 S DIXIE HWY
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5436
Country	:	US
Telephone Number	:	954-454-3883
Fax Number	:	954-454-1901

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

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. JANICE ROUSELLE DEFELICE D.M.D.” Practice Location

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