Provider Demographics
NPI:1841647161
Name:ROFF, ERICK MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:ERICK
Middle Name:MICHAEL
Last Name:ROFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2120 E JOHNSON AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6091
Mailing Address - Country:US
Mailing Address - Phone:850-494-3954
Mailing Address - Fax:850-494-6936
Practice Address - Street 1:2120 E JOHNSON AVE STE 106
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6091
Practice Address - Country:US
Practice Address - Phone:850-494-3954
Practice Address - Fax:850-494-6936
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS177912084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN