Provider Demographics
NPI:1376575548
Name:ROLA, SANDRA FAY (PT)
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:FAY
Last Name:ROLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:FAY
Other - Last Name:DOWNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-3147
Mailing Address - Country:US
Mailing Address - Phone:941-587-1303
Mailing Address - Fax:941-484-5487
Practice Address - Street 1:333 TAMIAMI TRL S
Practice Address - Street 2:SUITE 207
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2402
Practice Address - Country:US
Practice Address - Phone:941-484-2471
Practice Address - Fax:941-484-5487
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA13373225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant