Provider Demographics
NPI:1518023340
Name:ROURA, SAMUEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:E
Last Name:ROURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10621 SW 88TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8708
Mailing Address - Country:US
Mailing Address - Phone:305-969-9016
Mailing Address - Fax:305-971-0701
Practice Address - Street 1:10621 SW 88TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8708
Practice Address - Country:US
Practice Address - Phone:305-969-9016
Practice Address - Fax:305-971-0701
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME670882084P0800X
FLME 670882084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry