Provider Demographics
NPI:1265487185
Name:ROCA, FRINE T (MD)
Entity type:Individual
Prefix:DR
First Name:FRINE
Middle Name:T
Last Name:ROCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FRINE
Other - Middle Name:E
Other - Last Name:DE DIOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:205 GRAND AVE NW
Mailing Address - Street 2:STE B
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-2107
Mailing Address - Country:US
Mailing Address - Phone:256-979-1515
Mailing Address - Fax:256-979-1517
Practice Address - Street 1:205 GRAND AVE NW
Practice Address - Street 2:STE B
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-2107
Practice Address - Country:US
Practice Address - Phone:256-979-1515
Practice Address - Fax:256-979-1517
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00016324208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51003773OtherBCBS
AL541385602Medicaid
AL051557587Medicaid
AL51003773OtherBCBS
ALE17840Medicare UPIN