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General NPI Number Information
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NPI Number | 1174847321
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Entity Type | Individual
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Provider Name | SANDRA ROLDAN LMT
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Gender | Female
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 1801 S OCEAN DR SUITE E
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4945
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Country | US
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Telephone | 954-391-7864
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Fax | 954-391-8468
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Provider Business Mailing Address
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Address Line | 304 W HALLANDALE BEACH BLVD HALLANDALE BEACH , FL 33009
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5444
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Country | US
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Telephone | 954-454-4280
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Fax | 954-922-3841
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA44797
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License Number State | FL
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