Provider Demographics
NPI:1689758690
Name:ROCOURT, MARISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARISSA
Middle Name:
Last Name:ROCOURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 W HIBISCUS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2608
Mailing Address - Country:US
Mailing Address - Phone:321-259-5999
Mailing Address - Fax:321-259-5553
Practice Address - Street 1:1735 W HIBISCUS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-259-5999
Practice Address - Fax:321-259-5553
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81535207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine