Healthcare Provider Details

I. General information

NPI: 1063010395
Provider Name (Legal Business Name): ROCIO TAVERAS MSN, ARNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2020
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 NW 45TH ST
CORAL SPRINGS FL
33065-2120
US

IV. Provider business mailing address

850 NW 79TH AVE
MARGATE FL
33063-4046
US

V. Phone/Fax

Practice location:
  • Phone: 786-391-9709
  • Fax:
Mailing address:
  • Phone: 786-391-9709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11034258
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN9491841
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: