MEDICARE: MR. ROBERT RAY SCHROPE IV PA-C

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	363A00000X	Physician Assistant	4330	WI
2	363AM0700X	Medical Physician Assistant	079199	IA
3	363AM0700X	Medical Physician Assistant	085.005486	IL
4	363A00000X	Physician Assistant	1050384	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1861475006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT RAY SCHROPE IV PA-C

Provider Business Mailing Address
First Line	:	906 PALM BLVD S
Second Line	:
City	:	NICEVILLE
State	:	FL
Zip	:	32578-2603
Country	:	US
Telephone Number	:	850-517-9851
Fax Number	:

Provider Business Practice Location Address
First Line	:	12385 SORRENTO RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8664
Country	:	US
Telephone Number	:	850-517-9851
Fax Number	:

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

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	06/23/2023

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