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NPI Code Detail

MEDICARE: ROY ADCOCK

MEDICARE:   ROY  ADCOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerCBHCM103074FL
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1841845872
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROY ADCOCK
Provider Business Mailing Address
First Line : 3911 HOLLYWOOD BLVD STE 201
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6795
Country : US
Telephone Number : 954-639-7345
Fax Number :
Provider Business Practice Location Address
First Line : 1152 N UNIVERSITY DR
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33024-5000
Country : US
Telephone Number : 954-639-7345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 11/18/2020

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Directions to “ ROY ADCOCK ” Practice Location

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