Provider Demographics
NPI:1720778095
Name:ROVIRA ALVARADO, JOSE IGNACIO
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:IGNACIO
Last Name:ROVIRA ALVARADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BIEN-TE-VEO 87
Mailing Address - Street 2:URB. MONTEHIEDRA, SAN JUAN, PR
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-653-2481
Mailing Address - Fax:
Practice Address - Street 1:CARR. #5 AVENIDA CENTRAL JUANITA FINAL
Practice Address - Street 2:PUERTO RICO CORRECTIONAL HEALTH SERVICES CORP. - BAYAMA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-0096
Practice Address - Country:US
Practice Address - Phone:939-225-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program