Provider Demographics
NPI:1720078496
Name:ROSENCRANZ, RHONDA RAE (MPT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:RAE
Last Name:ROSENCRANZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17222 HOSPITAL BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-8906
Mailing Address - Country:US
Mailing Address - Phone:352-277-0300
Mailing Address - Fax:352-799-3751
Practice Address - Street 1:104 N TRAUTMAN AVE
Practice Address - Street 2:
Practice Address - City:BROADUS
Practice Address - State:MT
Practice Address - Zip Code:59317-7504
Practice Address - Country:US
Practice Address - Phone:406-436-2872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 210782251X0800X
MT15240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1506YMedicare ID - Type Unspecified