Provider Demographics
NPI:1386813681
Name:ROCHE, MANUEL (RRT)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:
Last Name:ROCHE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 LAUREL GLEN DR
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6833
Mailing Address - Country:US
Mailing Address - Phone:863-533-8737
Mailing Address - Fax:
Practice Address - Street 1:1326 LAUREL GLEN DR
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6833
Practice Address - Country:US
Practice Address - Phone:863-533-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT8970227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered