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General NPI Number Information
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NPI Number | 1487003422
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Entity Type | Individual
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Provider Name | MORAMED DESROCHES MD, PMNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 980 NORTH FEDERAL HIGHWAY SUITE 110 #1006
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City | BOCA RATON
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State | FL
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Zip | 33432
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Country | US
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Telephone | 561-786-5874
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Fax | 561-973-1964
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Provider Business Mailing Address
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Address Line | 980 NORTH FEDERAL HIGHWAY SUITE 110 #1006
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City | BOCA
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State | FL
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Zip | 33432-2043
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Country | US
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Telephone | 561-786-5874
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Fax | 561-973-1964
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TPPA183
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8885
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HSE35829
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 373-PA
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11026530
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License Number State | FL
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