# ROGER ROQUE MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St Francis Primary Care Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205571015
- **Authorized official:** MR. DAVID P WAGNER (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (321) 204-5222

## Contact information

- **Practice address:** 620 S LAKE ST STE 2, LEESBURG, FL 34748-6059
- **Practice address phone:** (352) 314-6589
- **Mailing address:** PO BOX 491500, LEESBURG, FL 34749-1500
- **Mailing address phone:** (352) 314-6589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2022
- **Last updated:** 02/03/2023