Provider Demographics
NPI:1568430551
Name:ROVIRA, JOSE M (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:ROVIRA
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:PO BOX 1520
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660
Mailing Address - Country:US
Mailing Address - Phone:787-849-0111
Mailing Address - Fax:787-849-0707
Practice Address - Street 1:CALLE LUIS MUNOZ MARIN #2
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-0111
Practice Address - Fax:787-849-0707
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9796208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
19796OtherCIGNA PREFERRED
6600010OtherHUMANA REFORMA
030385OtherBLUE CROSS BLUE SHIELD
6600010OtherHUMANA INSURANCE
19796OtherCIGNA EXCLUSIVE
81925OtherBLUE CROSS BLUE SHIELD
PR067931OtherCRUZ AZUL
6600010OtherHUMANA HEALTH
0119504OtherADMINISTRACION DE COMPENS
19796OtherCIGNA ESCOLAR
6600010OtherHUMANA REFORMA