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NPI 1760870315

NPI 1760870315 : ANABEL LUCIA ROQUE : PALMETTO BAY, FL

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General NPI Number Information
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    NPI Number           |    1760870315
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    Entity Type          |    Individual 
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    Provider Name        |    ANABEL LUCIA ROQUE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/06/2015
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    Last Update Date     |    01/06/2015
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Provider Practice Location Address
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    Address Line         |    9061 SW 156TH ST APT 208 
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    City                 |    PALMETTO BAY
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    State                |    FL
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    Zip                  |    33157-1971
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    Country              |    US
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    Telephone            |    786-488-5091
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9061 SW 156TH ST APT 208 
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    City                 |    PALMETTO BAY
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    State                |    FL
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    Zip                  |    33157-1971
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    Country              |    US
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    Telephone            |    786-488-5091
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    AP3583
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    License Number State |    FL
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