Provider Demographics
NPI:1295572337
Name:ROQUE, ADRIANA (NP)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:ROQUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9279 W 33RD LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2067
Mailing Address - Country:US
Mailing Address - Phone:786-374-6396
Mailing Address - Fax:
Practice Address - Street 1:9279 W 33RD LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-2067
Practice Address - Country:US
Practice Address - Phone:786-374-6396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029357363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care