Provider Demographics
NPI:1801436910
Name:ROQUE, VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ROQUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4767 NW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-2933
Mailing Address - Country:US
Mailing Address - Phone:305-266-2929
Mailing Address - Fax:305-627-3862
Practice Address - Street 1:4767 NW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-2933
Practice Address - Country:US
Practice Address - Phone:305-266-2929
Practice Address - Fax:305-627-3862
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024191319363LF0000X
FLRN9405352163W00000X
NY960793163W00000X
NY355287363LF0000X
GAGAA-NP002774363LF0000X
TX1176649363LF0000X
FLAPRN11005325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse