Provider Demographics
NPI:1295523991
Name:ROQUE, YARAIMY ERILIAN
Entity type:Individual
Prefix:
First Name:YARAIMY
Middle Name:ERILIAN
Last Name:ROQUE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 NW 21ST CT APT 203
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-6098
Mailing Address - Country:US
Mailing Address - Phone:305-889-8839
Mailing Address - Fax:
Practice Address - Street 1:5400 S UNIVERSITY DR STE 203
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5309
Practice Address - Country:US
Practice Address - Phone:305-889-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171400000XOther Service ProvidersHealth & Wellness Coach