Provider Demographics
NPI:1467743294
Name:ROCK, CYNTHIA (LMT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ROCK
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 1:1590 NE 162ND ST
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4759
Mailing Address - Country:US
Mailing Address - Phone:305-919-7877
Mailing Address - Fax:305-945-6445
Practice Address - Street 1:1590 NE 162ND ST
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4759
Practice Address - Country:US
Practice Address - Phone:305-919-7877
Practice Address - Fax:305-945-6445
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39190225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist