Miguel Alexis Roque Martinez, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN25764 Issued in FL

Practice address

2755 E Gulf to Lake Hwy
Inverness, FL 34453-3245

Phone

(352) 559-3379

NPI assigned

Mar 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1811523129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 E GULF TO LAKE HWY",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533245",
            "telephone_number": "352-559-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 E GULF TO LAKE HWY",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533245",
            "telephone_number": "352-559-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE MARTINEZ",
        "first_name": "MIGUEL",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-18",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Armando Luis Rojas, MD
• Carl W Rosebrough, MD
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• Susan B Rourke-Webb, PHARMD
• Abin Sabu, MD
• Kanta Saigal, MD

• Dentist in Inverness, FL
• Providers in Inverness, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.