Provider Demographics
NPI:1023310802
Name:ROCKFIELD, SUSAN A (LMT, LFS, MMP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:ROCKFIELD
Suffix:
Gender:F
Credentials:LMT, LFS, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9685 ARNAZ CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-4013
Mailing Address - Country:US
Mailing Address - Phone:941-697-5792
Mailing Address - Fax:
Practice Address - Street 1:9685 ARNAZ CIR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-4013
Practice Address - Country:US
Practice Address - Phone:941-697-5792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA53091225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist