Provider Demographics
NPI:1801960869
Name:SCAVELLA, ROCHELLE (RRT)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:
Last Name:SCAVELLA
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 NW WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:PSL
Mailing Address - State:FL
Mailing Address - Zip Code:34986
Mailing Address - Country:US
Mailing Address - Phone:305-301-4416
Mailing Address - Fax:
Practice Address - Street 1:5575 NW WESLEY CT
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986
Practice Address - Country:US
Practice Address - Phone:305-301-4416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT29952279H0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL681998296Medicaid
FL884612000Medicaid