MEDICARE: DR. OMAR ALBERTO PICADO ROQUE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	ME145680	FL

General Provider Information

NPI Number	:	1356845598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR ALBERTO PICADO ROQUE MD

Provider Business Mailing Address
First Line	:	2001 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1801
Country	:	US
Telephone Number	:	786-860-6004
Fax Number	:	305-441-9342

Provider Business Practice Location Address
First Line	:	1190 NW 95TH ST STE 302
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33150-2066
Country	:	US
Telephone Number	:	305-823-8510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2018
Last Update Date	:	09/11/2025

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