Individual
THERESA PRYOR ROCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5153 N 9TH AVE, PENSACOLA, FL 32504
(850) 505-4700
(850) 505-4711
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
ME92034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117936
—
MS
05
—
009934152
—
AL
05
—
273251300
—
FL
Enumeration date
01/05/2006
Last updated
07/17/2018
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