Provider Demographics
NPI:1386638435
Name:ROVIRA, JOSE R (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:ROVIRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 565006
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5006
Mailing Address - Country:US
Mailing Address - Phone:305-552-5354
Mailing Address - Fax:305-222-8444
Practice Address - Street 1:11760 SW 40TH ST
Practice Address - Street 2:SUITE 646
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3582
Practice Address - Country:US
Practice Address - Phone:305-552-5354
Practice Address - Fax:305-222-8444
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME25875207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0025875OtherWORK/COMP
GA60003194OtherRAILROAD MEDICAID
FL95530OtherBLUE SHIELD
D64806OtherVISTA
52081OtherJMH
209132OtherAVMED
FL95530OtherBLUE SHIELD
ME0025875OtherWORK/COMP