Theresa Pryor Roca, MD | |
5153 N 9th Ave, Pensacola, FL 32504 | |
(850) 505-4700 | |
(850) 505-4711 |
Full Name | Theresa Pryor Roca |
---|---|
Gender | Female |
Speciality | Pediatrics - Pediatric Cardiology |
Location | 5153 N 9th Ave, Pensacola, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861470239 | NPI | - | NPPES |
00117936 | Medicaid | MS | |
009934152 | Medicaid | AL | |
273251300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0202X | Pediatrics - Pediatric Cardiology | ME92034 (Florida) | Primary |
Entity Name | Florida Clinical Practice Association Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063463768 PECOS PAC ID: 0345146254 Enrollment ID: O20031211000099 |
Entity Name | Sacred Heart Health System Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1962453308 PECOS PAC ID: 3779491386 Enrollment ID: O20051015000049 |
Mailing Address | Practice Location Address |
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Theresa Pryor Roca, MD Po Box 191, Provider Enrollment Dept, Rockland, DE 19732-0191 Ph: (302) 651-6212 | Theresa Pryor Roca, MD 5153 N 9th Ave, Pensacola, FL 32504 Ph: (850) 505-4700 |
Elyse S Schrandt, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5151 N 9th Ave, Pensacola, FL 32504 Phone: 850-416-1575 | |
Prashanth Shanmugham, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5151 N 9th Ave, Pensacola, FL 32504 Phone: 850-416-4970 | |
Lisbeth Vernali, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4785 N 9th Ave, Suite A, Pensacola, FL 32503 Phone: 850-478-7600 | |
Gulnur Com, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1675 Trinity Dr, Pensacola, FL 32504 Phone: 850-416-1110 Fax: 850-416-1192 | |
John Frank Bullard Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2805 Bayou Blvd, Pensacola, FL 32503 Phone: 850-434-6881 Fax: 850-434-8999 | |
Mr. Roger C Clubbs, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4951 Grande Dr, Pensacola, FL 32504 Phone: 850-473-0100 Fax: 850-473-0500 | |
Robert K Wilson Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5192 Bayou Blvd, Pensacola, FL 32503 Phone: 850-484-5040 Fax: 850-475-5527 |