Provider Demographics
NPI:1396125241
Name:ROCHE, HILDA (APRN)
Entity type:Individual
Prefix:MRS
First Name:HILDA
Middle Name:
Last Name:ROCHE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 NW 89TH ST APT 210
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2375
Mailing Address - Country:US
Mailing Address - Phone:305-803-8904
Mailing Address - Fax:
Practice Address - Street 1:11201 NW 89TH ST APT 210
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2375
Practice Address - Country:US
Practice Address - Phone:305-803-8904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030082363LF0000X
CO15-198246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant