Provider Demographics
NPI:1952940413
Name:PHILOCLES, LAROCHE (PT)
Entity type:Individual
Prefix:DR
First Name:LAROCHE
Middle Name:
Last Name:PHILOCLES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7536 NE 1ST CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-4902
Mailing Address - Country:US
Mailing Address - Phone:786-704-3150
Mailing Address - Fax:
Practice Address - Street 1:7536 NE 1ST CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-4902
Practice Address - Country:US
Practice Address - Phone:786-704-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35348251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health