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Organization

JOSE R ROVIRA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE R ROVIRA MD (PRESIDENT)
(305) 552-5354
Entity
Organization

Contact information

Practice address
11760 SW 40 STREET, SUITE 646, MIAMI, FL 33175-8101
(305) 552-5354
(305) 222-8444
Mailing address
PO BOX 565006, MIAMI, FL 33256-5006
(305) 552-5354
(305) 222-8444

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME25875
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
065067600
FL
01
95530
BLUE SHIELD
FL
Enumeration date
07/07/2010
Last updated
07/07/2010
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