MEDICARE: DR. JENNIFER JONES ROCHA D.M.D.

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
1	1223G0001X	General Practice Dentistry	DN18275	FL

General Provider Information

NPI Number	:	1518125665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER JONES ROCHA D.M.D.

Provider Business Mailing Address
First Line	:	13510 N ROME AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2027
Country	:	US
Telephone Number	:	813-269-9466
Fax Number	:

Provider Business Practice Location Address
First Line	:	13510 N ROME AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2027
Country	:	US
Telephone Number	:	813-269-9466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	03/30/2011

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