MEDICARE: HEATHER ROKA

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	225100000X	Physical Therapist	26597	FL

General Provider Information

NPI Number	:	1811362783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER ROKA

Provider Business Mailing Address
First Line	:	3810 CLEARBROOK LN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-7005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 CLEARBROOK LN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-7005
Country	:	US
Telephone Number	:	800-330-7711
Fax Number	:

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

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	12/03/2015

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Directions to “ HEATHER ROKA ” Practice Location

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