Provider Demographics
NPI:1972384568
Name:ROZHANSKIY, ROCHAEL SAVANNAH (LMT)
Entity Type:Individual
Prefix:
First Name:ROCHAEL
Middle Name:SAVANNAH
Last Name:ROZHANSKIY
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 1:10447 SORRENTO RD
Mailing Address - Street 2:SUITE 100 PMB 102
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507
Mailing Address - Country:US
Mailing Address - Phone:208-541-4826
Mailing Address - Fax:
Practice Address - Street 1:5018 GRANDE DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8950
Practice Address - Country:US
Practice Address - Phone:850-477-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 171400000X
FLMA103707225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach