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General NPI Number Information
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NPI Number | 1346060738
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Entity Type | Individual
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Provider Name | YOLAYDA ROQUE APRN
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Gender | Female
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 401 N PARSONS AVE
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City | BRANDON
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State | FL
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Zip | 33510-4538
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Country | US
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Telephone | 813-505-8467
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 COASTAL HAMMOCK AVE FL 33570
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City | RUSKIN
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State | FL
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Zip | 33570-2205
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Country | US
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Telephone | 813-505-8467
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11035873
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | APRN11035873
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number | APRN11035873
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License Number State | FL
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