Provider Demographics
NPI:1275654733
Name:ALLEN, ROCHELLE CRUZ (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:CRUZ
Last Name:ALLEN
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 1:14907 GREELEY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-1963
Mailing Address - Country:US
Mailing Address - Phone:813-298-8299
Mailing Address - Fax:
Practice Address - Street 1:19007 N DALE MABRY
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548
Practice Address - Country:US
Practice Address - Phone:813-298-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-41936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC3009OtherBLUE CROSS BLUE SHIELD