Provider Demographics
NPI:1245840461
Name:MEDEROS ROCHA, NATASHA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:MEDEROS ROCHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:MEDEROS ROCHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:580 WEST 8TH ST.
Mailing Address - Street 2:TOWER 1, 5TH FLOOR, SUITE 513
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209
Mailing Address - Country:US
Mailing Address - Phone:904-383-1013
Mailing Address - Fax:904-244-7893
Practice Address - Street 1:580 WEST 8TH ST.
Practice Address - Street 2:TOWER 1, 5TH FLOOR, SUITE 513
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-383-1013
Practice Address - Fax:904-244-7893
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2025-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program