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NPI Code Detail

MEDICARE: MARY R ROLLO MSW

MEDICARE: MARY R ROLLO MSW
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
11041C0700XClinical Social WorkerSW15695FL
2101YM0800XMental Health CounselorSW15695FL
3104100000XSocial WorkerISW10074FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720593338
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY R ROLLO MSW
Provider Business Mailing Address
First Line : 6770 WEATHERED DR
Second Line :
City : MILTON
State : FL
Zip : 32570-2210
Country : US
Telephone Number : 850-384-1712
Fax Number :
Provider Business Practice Location Address
First Line : 112 W CERVANTES ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3128
Country : US
Telephone Number : 850-466-3200
Fax Number : 850-466-3203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2017
Last Update Date : 03/12/2026

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Directions to “ MARY R ROLLO MSW” Practice Location

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