Diana Marcela Roldan Mora

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

883 Crystal Lake Dr
Deerfield Beach, FL 33064-1948

Phone

(786) 312-5827

NPI assigned

Mar 21, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Diana Marcela Roldan Mora Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dynamic Motion Rehab Inc

  • Early Intervention Provider Agency
  • Deerfield Beach, FL
  • NPI 1275114605

  Developmental Therapist

  NPD Authorized official

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1578862207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 CRYSTAL LAKE DR",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330641948",
            "telephone_number": "786-312-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 CRYSTAL LAKE DR",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330641948",
            "telephone_number": "786-312-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN MORA",
        "first_name": "DIANA",
        "middle_name": "MARCELA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA21898",
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014924900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "ROLDAN MORA",
            "middle_name": "MARCELA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alexandra Rojas
• Diana Patricia Rojas
• Juan Carlos Rojas
• Megan Rose Rojas
• Yessenia Tiffany Rojas
• Arlene Roldan
• Chelsea Charda Rolle
• Alison Roloff, PA-C
• Mike Romain
• Natalia Romanenko

• Developmental Therapist in Deerfield Beach, FL
• Providers in Deerfield Beach, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.