Healthcare Provider Details

I. General information

NPI: 1316852569
Provider Name (Legal Business Name): ROXANA TROCHE CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 SE 12TH AVE STE 2829
HOMESTEAD FL
33034-2699
US

IV. Provider business mailing address

13102 SW 132ND TER
MIAMI FL
33186-7457
US

V. Phone/Fax

Practice location:
  • Phone: 786-640-1424
  • Fax: 786-601-7124
Mailing address:
  • Phone: 786-908-4826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number692178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: