Provider Demographics
NPI:1922540319
Name:RHODES, MICHELLE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20525 GRAND VISTA LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3456
Mailing Address - Country:US
Mailing Address - Phone:813-390-2206
Mailing Address - Fax:813-501-8837
Practice Address - Street 1:20525 GRAND VISTA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3456
Practice Address - Country:US
Practice Address - Phone:813-390-2206
Practice Address - Fax:813-501-8837
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3035192163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator