MEDICARE: MAGALY ROUZIER MD

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	207Q00000X	Family Medicine Physician	226224	NY
2	207Q00000X	Family Medicine Physician	ME86524	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	:	1659366060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGALY ROUZIER MD

Provider Business Mailing Address
First Line	:	5475 NW SAINT JAMES DR
Second Line	:	#148
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-3444
Country	:	US
Telephone Number	:	917-656-7640
Fax Number	:	772-344-8852

Provider Business Practice Location Address
First Line	:	5475 NW SAINT JAMES DR
Second Line	:	#148
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-3444
Country	:	US
Telephone Number	:	917-656-7640
Fax Number	:	772-344-8852

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	06/19/2015

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