Provider Demographics
NPI:1922173426
Name:KNOWLES, ROCHELLE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCHELLE
Middle Name:MARIE
Last Name:KNOWLES
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:VETERANS HEALTH SYSTEM
Mailing Address - Street 2:2804 W. MARC KNIGHTON CT., SUITE A
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461
Mailing Address - Country:US
Mailing Address - Phone:352-746-8009
Mailing Address - Fax:
Practice Address - Street 1:8900 SE 165TH MULBERRY LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5884
Practice Address - Country:US
Practice Address - Phone:352-674-5000
Practice Address - Fax:352-674-5030
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376463000Medicaid
FL376463000Medicaid