Provider Demographics
NPI:1427754308
Name:THOMAS ROLLE, TYPHANY E
Entity type:Individual
Prefix:
First Name:TYPHANY
Middle Name:E
Last Name:THOMAS ROLLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19100 NW 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2043
Mailing Address - Country:US
Mailing Address - Phone:305-731-5327
Mailing Address - Fax:
Practice Address - Street 1:4180 SW 74TH CT STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4443
Practice Address - Country:US
Practice Address - Phone:786-464-0369
Practice Address - Fax:786-332-2882
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT14841227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified