Provider Demographics
NPI:1750380903
Name:ROCHA, RAFAEL L (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:L
Last Name:ROCHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:1840 MEASE DR STE 409
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6606
Practice Address - Country:US
Practice Address - Phone:727-443-8450
Practice Address - Fax:727-533-5911
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2021-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0071857207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006097400Medicaid
FLP01219568OtherRAILROAD MEDICARE PROVIDER NUMBER
FL32747XMedicare PIN
G08040Medicare UPIN