Individual provider Active NPI

Coralia Rosa Roca, M.D.

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1043539265
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN 376 Issued in FL
Practice address
540 NW 165TH St Ste 310
Miami, FL 33169-6342
Phone
(786) 562-7479
Fax
(305) 564-7610
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18,001 PR
General Practice Physician 208D00000X ACN 376 FL Primary

Addresses

Primary practice location

540 NW 165TH St Ste 310
Miami, FL 33169-6342

Mailing address

540 NW 165TH St Ste 310
Miami, FL 33169-6342
Phone (786) 562-7479

Other identifiers 1

IdentifierTypeStateIssuer
007653300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130828000971 FL Practitioner - General Practice 4688868615 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ACN 376FLMDGeneral Practice Physician
18,001PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mar Medical Center LLC CurrentSince Sep 13, 2025 Accepting new patients
VA Physical Rehabilitation Corp CurrentSince Oct 31, 2025 Accepting new patients
Lba Medical Services Inc General Practice PastSince Sep 5, 2017 Accepting new patients
Florida Department of Health Past Accepting new patients

Locations

633 N Krome Ave
Ste 5
Homestead, FL 33030
Phone (786) 339-9736

974 Old Dixie Hwy
Homestead, FL 33030
Phone (305) 246-9998

7821 Coral Way
Ste 129
Miami, FL 33155
Phone (305) 266-4651

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1043539265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 NW 165TH ST STE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696342",
            "telephone_number": "786-562-7479",
            "fax_number": "305-564-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 NW 165TH ST STE 310",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696342",
            "telephone_number": "786-562-7479",
            "fax_number": "305-564-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCA",
        "first_name": "CORALIA",
        "middle_name": "ROSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18,001",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007653300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.