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Organization
MARTIN M ROCHE MD PA
Active
Organization
MARTIN M ROCHE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN M ROCHE MD (MEDICAL DIRECTOR)
(954) 462-7558
Entity
Organization
Contact information
Practice address
500 SE 17TH ST, SUITE 100, FT LAUDERDALE, FL 33316-2547
(954) 462-7558
(954) 525-5820
Mailing address
500 SE 17TH ST, SUITE 100, FT LAUDERDALE, FL 33316-2547
(954) 462-7558
(954) 525-5820
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06962
BLUECROSS OF FLORIDA
FL
Enumeration date
06/12/2007
Last updated
07/28/2009
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