# COMPREHENSIVE ORTHOPAEDICS OF THE GULF COAST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013452804
- **Authorized official:** JASON ROCHA MD (PRESIDENT)
- **Authorized official phone:** (850) 492-7775

## Contact information

- **Practice address:** 3298 SUMMIT BLVD STE 4, PENSACOLA, FL 32503
- **Practice address phone:** (850) 492-7775
- **Practice address fax:** (888) 974-1051
- **Mailing address:** 3298 SUMMIT BLVD STE 4, PENSACOLA, FL 32503-4350
- **Mailing address phone:** (850) 492-7775
- **Mailing address fax:** (888) 974-1051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/03/2017
- **Last updated:** 07/25/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003141200 | — | FL |
| 01 | — | 7653620001 | NCS-MEDICARE | FL |