Provider Demographics
NPI:1013997683
Name:ROCKER, JEFFRY F (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:F
Last Name:ROCKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ALAFAYA WOODS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6241
Mailing Address - Country:US
Mailing Address - Phone:407-366-3577
Mailing Address - Fax:407-366-2646
Practice Address - Street 1:110 ALAFAYA WOODS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6241
Practice Address - Country:US
Practice Address - Phone:407-366-3577
Practice Address - Fax:407-366-2646
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080124904OtherMEDICARE RAILROAD
FL080124904OtherMEDICARE RAILROAD
FLE89695Medicare UPIN