Individual
MADISON BELOU ROVIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 BELLE CHASSE HWY, TERRYTOWN, LA 70056-7127
(800) 893-9698
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
324467
LA
363AM0700X
Medical Physician Assistant
0110-007424
VA
363AS0400X
Surgical Physician Assistant
0110-007424
VA
Other
Enumeration date
11/04/2020
Last updated
08/05/2024
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