MEDICARE: ROVICO HEALTH CARE ADMINISTRATIVE AND CONSULTING SERVICES INC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	CASM0232	PR

General Provider Information

NPI Number	:	1629047105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROVICO HEALTH CARE ADMINISTRATIVE AND CONSULTING SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 880
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0880
Country	:	US
Telephone Number	:	787-806-1835
Fax Number	:	787-986-1835

Provider Business Practice Location Address
First Line	:	237 AVE. FLAMBOYAN
Second Line	:	ROAD 116 KM.2
City	:	LAJAS
State	:	PR
Zip	:	00667-2509
Country	:	US
Telephone Number	:	787-808-1835
Fax Number	:	787-899-1835

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. RUTH M ORTIZ
Credential	:	MHSA,RHIA
Telephone Number	:	787-806-1835

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	09/02/2010

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