Provider Demographics
NPI:1154433399
Name:FERNANDEZ-ROQUE, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:FERNANDEZ-ROQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SUNSET HARBOR DR
Mailing Address - Street 2:#1512
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1400
Mailing Address - Country:US
Mailing Address - Phone:305-662-7551
Mailing Address - Fax:
Practice Address - Street 1:7340 SW 48TH ST
Practice Address - Street 2:#107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5520
Practice Address - Country:US
Practice Address - Phone:305-662-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY131231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist