Individual provider Active NPI

Walfrido Roque, APRN

  • Family Nurse Practitioner
  • Hialeah, FL
National Provider Identifier
1447746441
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9318612 Issued in FL
Practice address
315 W 9TH St
Hialeah, FL 33010-3853
Phone
(786) 703-1536
NPI assigned
Jul 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9318612 FL Primary

Addresses

Primary practice location

315 W 9TH St
Hialeah, FL 33010-3853

Mailing address

267 E 51St St
Hialeah, FL 33013-1424
Phone (786) 973-1357

Other practice location 1

10920 W Flagler St Ste 201
Miami, FL 33174-1243
Phone (786) 623-3915

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
I20191113002505 FL Practitioner - Nurse Practitioner 8426480468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9318612FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Doctors Group LLC PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1447746441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 E 51ST ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330131424",
            "telephone_number": "786-973-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 9TH ST",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330103853",
            "telephone_number": "786-703-1536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10920 W Flagler St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331741243",
            "country_code": "US",
            "telephone_number": "786-623-3915",
            "fax_number": "786-623-3916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "WALFRIDO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9318612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.