Provider Demographics
NPI:1851542427
Name:ROCHA, JASON R (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:ROCHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 95590
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-0590
Mailing Address - Country:US
Mailing Address - Phone:801-784-0954
Mailing Address - Fax:801-352-7976
Practice Address - Street 1:125 BAPTIST WAY STE 4A
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2274
Practice Address - Country:US
Practice Address - Phone:448-227-6360
Practice Address - Fax:850-437-8649
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2025-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY292091207XX0801X
FLME108684207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115570400Medicaid
FLWI338OtherMEDICARE