Provider Demographics
NPI:1528032745
Name:MAROWITZ, ROBERTA LEE (EDD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:LEE
Last Name:MAROWITZ
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 NIBLICK DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-4422
Mailing Address - Country:US
Mailing Address - Phone:407-865-3855
Mailing Address - Fax:
Practice Address - Street 1:237 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8433
Practice Address - Country:US
Practice Address - Phone:407-865-3855
Practice Address - Fax:321-203-2512
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMFT652101Y00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ095SOtherBLUE CROSS BLUE SHIELD FL
FLMFT652OtherLICENSED MARRIAGE & FAM T