Provider Demographics
NPI:1790893949
Name:CANDO ROVIRA, KAREM (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAREM
Middle Name:
Last Name:CANDO ROVIRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 13TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4103
Mailing Address - Country:US
Mailing Address - Phone:407-900-4885
Mailing Address - Fax:866-515-9293
Practice Address - Street 1:2521 13TH ST STE F
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4103
Practice Address - Country:US
Practice Address - Phone:407-900-4885
Practice Address - Fax:866-515-9293
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2529103TC0700X
FL9932103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9932OtherFLORIDA DEPARTMENT OF HEALTH
PR0058167OtherMEDICARE PTAN