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General NPI Number Information
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NPI Number | 1366711293
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Entity Type | Individual
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Provider Name | GABRIEL ARCADIO ROCHA PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 5801 EXECUTIVE CENTER DR
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City | CHARLOTTE
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State | NC
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Zip | 28212-8861
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Country | US
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Telephone | 704-863-1550
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Fax |
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Provider Business Mailing Address
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Address Line | 10820 BOYKIN PL APT 110
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City | MATTHEWS
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State | NC
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Zip | 28105-8991
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Country | US
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Telephone | 910-261-7336
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA21284
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-04610
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License Number State | NC
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