Provider Demographics
NPI:1033445325
Name:WORKMAN, ROXANNE R (LMT)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:R
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16476 MAHAN DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-8688
Mailing Address - Country:US
Mailing Address - Phone:850-580-1573
Mailing Address - Fax:850-431-4856
Practice Address - Street 1:3521 MACLAY BLVD S
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-3913
Practice Address - Country:US
Practice Address - Phone:850-508-1573
Practice Address - Fax:850-431-4856
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 30338225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC9102OtherBCBS