Individual provider Active NPI

Mirianellys Roque, CNM

  • Midwife
  • Pembroke Pines, FL
National Provider Identifier
1306368394
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
ARNP9346741 Issued in FL
Practice address
1000 N Hiatus Rd Ste 160
Pembroke Pines, FL 33026-3096
Phone
(954) 900-6207
Fax
(954) 807-3509
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X ARNP9346741 FL Primary

Addresses

Primary practice location

1000 N Hiatus Rd Ste 160
Pembroke Pines, FL 33026-3096

Mailing address

1000 N Hiatus Rd Ste 160
Pembroke Pines, FL 33026-3096
Phone (954) 900-6207

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address welovetlc@outlook.com
Direct Messaging Address welovetlc@outlook.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191127000089 FL Practitioner - Nurse Practitioner 3577996875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 N Hiatus Rd
Suite 160
Pembroke Pines, FL 33026-3096
Phone (954) 900-6207

Hospital & facility affiliations

  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9346741FLMDMidwife

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1306368394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N HIATUS RD STE 160",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263096",
            "telephone_number": "954-900-6207",
            "fax_number": "954-807-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N HIATUS RD STE 160",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263096",
            "telephone_number": "954-900-6207",
            "fax_number": "954-807-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "MIRIANELLYS",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "FL",
            "license": "ARNP9346741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "welovetlc@outlook.com",
            "affiliation": "N",
            "address_1": "1000 N Hiatus Rd Ste 160",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330263096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "welovetlc@outlook.com",
            "affiliation": "N",
            "address_1": "1000 N Hiatus Rd Ste 160",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330263096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.