Provider Demographics
NPI:1861475006
Name:SCHROPE, ROBERT RAY IV (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RAY
Last Name:SCHROPE
Suffix:IV
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 PALM BLVD S
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-2603
Mailing Address - Country:US
Mailing Address - Phone:850-517-9851
Mailing Address - Fax:
Practice Address - Street 1:12385 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8664
Practice Address - Country:US
Practice Address - Phone:850-517-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4330363A00000X
IA079199363AM0700X
IL085.005486363AM0700X
FL1050384363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty