Provider Demographics
NPI:1083769418
Name:ROCCO, ANGELO GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:GREGORY
Last Name:ROCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 HILLSBORO MILE
Mailing Address - Street 2:214S
Mailing Address - City:HILLSBORO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1703
Mailing Address - Country:US
Mailing Address - Phone:954-590-4141
Mailing Address - Fax:
Practice Address - Street 1:2 FENWAY PLZ
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2518
Practice Address - Country:US
Practice Address - Phone:617-421-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA#24261207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery