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General NPI Number Information
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NPI Number | 1255873063
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Entity Type | Individual
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Provider Name | HECTOR DEJESUS ROCHA ARNP
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Gender | Male
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 11600 LAKESIDE VILLAGE LN
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City | WINDERMERE
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State | FL
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Zip | 34786-7024
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Country | US
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Telephone | 407-876-2273
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Fax | 407-347-4450
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Provider Business Mailing Address
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Address Line | 3300 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-4306
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Country | US
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Telephone | 407-876-2273
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Fax | 407-347-4450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9242433
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License Number State | FL
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