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Individual

MR. GEORGE NORMAN ROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5399 EAST COUNTY HIGHWAY 30A, SUITE 5, SANTA ROSA BEACH, FL 32459-6718
(850) 231-6200
(850) 231-3500
Mailing address
5399 E COUNTY HIGHWAY 30A, SUITE 5, SANTA ROSA BEACH, FL 32459-6717
(850) 231-6200
(850) 231-3500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA31941FL
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
290446200
FL
Enumeration date
11/10/2006
Last updated
12/18/2013
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