Provider Demographics
NPI:1811196850
Name:ROVI INTEGRAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ROVI INTEGRAL MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-858-4700
Mailing Address - Street 1:2200 SW 16TH ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2067
Mailing Address - Country:US
Mailing Address - Phone:305-858-4700
Mailing Address - Fax:305-858-4842
Practice Address - Street 1:2200 SW 16TH ST
Practice Address - Street 2:SUITE 122
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2067
Practice Address - Country:US
Practice Address - Phone:305-858-4700
Practice Address - Fax:305-858-4842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC7541OtherAHCA