Provider Demographics
NPI:1841427564
Name:ROCA, MEL F (MD)
Entity Type:Individual
Prefix:DR
First Name:MEL
Middle Name:F
Last Name:ROCA
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:PO BOX 642117
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-8117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2201 W BROADWAY
Practice Address - Street 2:SUITE 9
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3605
Practice Address - Country:US
Practice Address - Phone:712-328-9100
Practice Address - Fax:712-328-0095
Is Sole Proprietor?:No
Enumeration Date:2009-06-20
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108140207Q00000X
IA38891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine