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NPI Code Detail

MEDICARE: MR. FERNANDO JESUS ROCHA PHARMD

MEDICARE: MR. FERNANDO JESUS ROCHA PHARMD
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
1183500000XPharmacist051.301359IL
2183500000XPharmacist20049NV

General Provider Information

NPI Number : 1811590805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FERNANDO JESUS ROCHA PHARMD
Provider Business Mailing Address
First Line : 9904 POPLAR POINT CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8491 FARM RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-8241
Country : US
Telephone Number : 702-396-1713
Fax Number : 702-765-4415
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2020
Last Update Date : 11/20/2020

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