Provider Demographics
NPI:1386494821
Name:DE MELLO SOUZA ROQUE, MARIANNA (MD)
Entity type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:DE MELLO SOUZA ROQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 SW 40TH ST. HCA FLORIDA KENDALL HOSPITAL-
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-223-3000
Mailing Address - Fax:
Practice Address - Street 1:11750 SW 40TH ST. HCA FLORIDA KENDALL HOSPITAL-
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-223-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program