Healthcare Provider Details

I. General information

NPI: 1225847890
Provider Name (Legal Business Name): ROCIO REYES ECHEMENDIA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11373 SW 211TH ST STE 21
MIAMI FL
33189-2247
US

IV. Provider business mailing address

11373 SW 211TH ST STE 21
MIAMI FL
33189-2247
US

V. Phone/Fax

Practice location:
  • Phone: 786-732-0032
  • Fax:
Mailing address:
  • Phone: 786-481-3928
  • Fax: 786-648-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11036980
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: