Florence C Roque, DNP, CPNP
Individual provider Active NPI Pediatric Nurse Practitioner · Deming, NM
NPI 1376626564 · NPPES record last updated Oct 21, 2021
Key facts
- NPI
- 1376626564
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- CNP-01614 (NM)
- Practice address
- 1020 S 8TH St
Suite a
Deming, NM 88030-4007 - Phone
- (575) 936-4350
- Fax
- (575) 936-4351
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Pediatric and Family Care, LLC
Practice addresses (Care Compare)
1020 S 8TH St
Suite a
Deming, NM 88030-4007
Phone (575) 936-4350
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150713001586 | NM | Practitioner - Nurse Practitioner | 1850375304 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP-01614 | NM | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Therapeutics LLC | Current |
Accepting new patients | |
| Southwest Pediatric and Family Care, LLC | Pediatrics | Current |
Accepting new patients |
Locations
1020 S 8th St
Ste A
Deming, NM 88030
Phone (575) 936-4350
1020 S 8th St
Deming, NM 88030
Phone (505) 546-1059
1419 S Santa Barbara St
Deming, NM 88030
Phone (575) 546-2684
Interoperability endpoints
- swpedscaregmail.com@spc-nm.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | CNP-01614 | NM | Yes |
Addresses
Primary practice location
1020 S 8TH St
Suite a
Deming, NM 88030-4007
Mailing address
1020 S 8TH St
Suite a
Deming, NM 88030-4007
Phone (575) 936-4350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5558582 | Medicaid | NM | |
| 965048 | Medicaid | AZ |
Other providers in Deming, NM
- Robert a Graor, M.D.
- Venus Robles
- Rocky Mountain Holdings, LLC
- Lizzette Rodriguez
- Rosa Ysela Rodriguez
- Inez Sargent Rottman
- Brisa Ney Ruiz I
- Jessica Ruiz
- Raul Ruiz
- Rural RX
All providers in Deming, NM · Pediatric Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.