Provider Demographics
NPI:1013053289
Name:ROVIROSA, DANIEL ANTONIO (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ANTONIO
Last Name:ROVIROSA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 ROYAL PALM BLVD SUITE 102
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-755-8003
Mailing Address - Fax:954-989-8380
Practice Address - Street 1:8150 ROYAL PALM BLVD SUITE 102
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-755-8003
Practice Address - Fax:954-989-8380
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist