Provider Demographics
NPI:1235020942
Name:PANAGUITON, MARY ROCHELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:MARY ROCHELLE
Middle Name:
Last Name:PANAGUITON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARY ROCHELLE
Other - Middle Name:M
Other - Last Name:PANAGUITON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:3962 VIAMONTE LN
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-2398
Mailing Address - Country:US
Mailing Address - Phone:863-397-2975
Mailing Address - Fax:
Practice Address - Street 1:1324 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4543
Practice Address - Country:US
Practice Address - Phone:863-687-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9256587163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse