Provider Demographics
NPI:1801436910
Name:ROQUE, VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ROQUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19161 NW 57TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5042
Mailing Address - Country:US
Mailing Address - Phone:786-488-3304
Mailing Address - Fax:
Practice Address - Street 1:19161 NW 57TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5042
Practice Address - Country:US
Practice Address - Phone:786-488-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9405352163W00000X
NY960793163W00000X
TX1176649363L00000X, 363LF0000X
AZ326247363L00000X
NY355287363LF0000X
VA0024191319363LF0000X
GAGAA-NP002774363LF0000X
FLAPRN11005325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner