Provider Demographics
NPI:1497042998
Name:VIDRI ALONSO-ROCHI, ROBERTO JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:JAVIER
Last Name:VIDRI ALONSO-ROCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 LORILLARD CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3808
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 CAMPUS AVE STE 401
Practice Address - Street 2:ST. MARY'S SURGICAL ASSOCIATES
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6045
Practice Address - Country:US
Practice Address - Phone:207-777-8650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-03446208600000X
MEMD 21008208600000X
RILP02286208600000X
WI1223208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery