Organization
ROCKLEDGE PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISHA FALK (VP OF CONTRACTING)
(800) 893-9698
Entity
Organization
Contact information
Practice address
110 LONGWOOD AVE, ROCKLEDGE, FL 32955-2828
(321) 636-2211
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017402700
—
FL
Enumeration date
04/08/2016
Last updated
05/17/2021
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