Provider Demographics
NPI:1407262942
Name:BAPTISTE, ROXANNE (MA76337)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:MA76337
Other - Prefix:MS
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:BAPTISTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:7595 BAYMEADOWS CIR W APT 1111
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1856
Mailing Address - Country:US
Mailing Address - Phone:267-257-4646
Mailing Address - Fax:
Practice Address - Street 1:7595 BAYMEADOWS CIR W APT 1111
Practice Address - Street 2:MOBILE
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1856
Practice Address - Country:US
Practice Address - Phone:267-257-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-04
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA76337225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist