Provider Demographics
NPI:1659366060
Name:ROUZIER, MAGALY (MD)
Entity Type:Individual
Prefix:
First Name:MAGALY
Middle Name:
Last Name:ROUZIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 NW SAINT JAMES DR
Mailing Address - Street 2:#148
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3444
Mailing Address - Country:US
Mailing Address - Phone:917-656-7640
Mailing Address - Fax:772-344-8852
Practice Address - Street 1:5475 NW SAINT JAMES DR
Practice Address - Street 2:#148
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3444
Practice Address - Country:US
Practice Address - Phone:917-656-7640
Practice Address - Fax:772-344-8852
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY226224207Q00000X
FLME86524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I00773Medicare UPIN
I00773Medicare UPIN