Individual ProviderWildalis RoviraGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address#15 Dr. Basora St., Hospital Perea, Mayaguez, PR 00680(787) 834-0101(787) 439-7259PECOS EnrollmentBased on the most recent information from CMS, provider Wildalis Rovira does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1649426255Provider TypeIndividualFull NameRovira, WildalisCredentialMDGenderFemaleSole ProprietorYesEnumeration Date8/14/2008Last Updated3/25/2011Contact InformationPractice LocationPractice Address#15 Dr. Basora St., Hospital Perea, Mayaguez, PR 00680Phone(787) 834-0101FaxUnlisted FaxMailing LocationMailing AddressPO Box 601, Mayaguez, PR 00681-0601Phone(787) 439-7259Fax(787) 265-5951Provider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense17176Puerto Rico