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Organization
ROGER C ROQUE MD PA
Active
Organization
ROGER C ROQUE MD PA
Active
Other names
St. Francis Primary Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER CAGANDAHAN ROQUE M.D. (FAMILY PHYSICIAN)
(352) 357-1014
Entity
Organization
Contact information
Practice address
720 N BAY ST, SUITE 8, EUSTIS, FL 32726-2964
(352) 357-1014
(352) 357-3130
Mailing address
PO BOX 1386, EUSTIS, FL 32727-1386
(352) 357-1014
(352) 357-3130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0070970
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279151000
—
FL
01
—
31407
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/22/2006
Last updated
08/23/2011
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