Healthcare Provider Details

I. General information

NPI: 1396125241
Provider Name (Legal Business Name): HILDA ROCHE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 PALM AVE
HIALEAH FL
33012-4034
US

IV. Provider business mailing address

11201 NW 89TH ST APT 210
DORAL FL
33178-2375
US

V. Phone/Fax

Practice location:
  • Phone: 786-600-7560
  • Fax:
Mailing address:
  • Phone: 305-803-8904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number11030082
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11030082
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: