Provider Demographics
NPI:1457557225
Name:ROVIRA, MADELYN (MD)
Entity Type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:ROVIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CALLE FALCON
Mailing Address - Street 2:MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9536
Mailing Address - Country:US
Mailing Address - Phone:787-272-2230
Mailing Address - Fax:
Practice Address - Street 1:65 CALLE FALCON
Practice Address - Street 2:MONTEHIEDRA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9536
Practice Address - Country:US
Practice Address - Phone:787-272-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12881208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation