Healthcare Provider Details

I. General information

NPI: 1518384528
Provider Name (Legal Business Name): ROCCIA MARIA OLIVEIRA DRISCOLL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 S PATRICK DR
PATRICK AFB FL
32925-3606
US

IV. Provider business mailing address

1381 S PATRICK DR # 2113
PATRICK AFB FL
32925-3606
US

V. Phone/Fax

Practice location:
  • Phone: 321-494-0936
  • Fax:
Mailing address:
  • Phone: 321-494-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number18526
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number32342
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT32342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: