DR. MARK D ROQUE (NPI# 1164427043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164427043 |
| Entity Type | Individual |
| Full Name | DR. MARK D ROQUE |
| Credential | M.D. |
| Practice Address |
410 Waymont Ct Lake Mary FL 32746-3485 |
| Practice Telephone | 4073233550 |
| Practice Fax Number | 4073226127 |
| Mailing Telephone | 4073233550 |
| Mailing Fax Number | 4073226127 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2017-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME82763 | FL | Other Service Providers |
| Y | 208000000X | Pediatrics | ME82763 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467802892 | Mark Christopher Roque | Nurse Practitioner | 13933 17th St, Suite 101, Dade City, FL 33525-4604 | 2016-06-16 |
| Street Address |
410 WAYMONT CT |
| City | LAKE MARY |
| State | FL |
| Zip Code | 32746-3485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821081 | Miles M Landis | Specialist | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2005-06-16 |
| 1568825768 | Alexa Rae Heller | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746 | 2016-04-04 |
| 1710347620 | Nicholas Edward Constantino | Physician Assistant | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2016-03-04 |
| 1932579224 | Allison Maccollom West | Nurse Practitioner | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2015-09-30 |
| 1992142426 | Analise Paige Casey | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2013-05-23 |
| 1215218441 | Miles M. Landis, M.d. P.a. | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2011-09-01 |
| 1184941155 | Sarah C Li | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2010-04-29 |
| 1801064605 | Cynthia Walker | Nurse Practitioner | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2008-02-14 |
| 1114195013 | Dawn Ellis | Physician Assistant | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2008-02-13 |
| 1902886773 | Thomas J. Alber | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2006-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286397 | James Maggert | Physical Therapist | Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 | 2020-05-14 |
| 1225663743 | Jamie Pecot | Behavior Technician | 300 International Parkway, 200, Lake Mary, FL 32746 | 2020-03-04 |
| 1619509585 | Dental Associates of Heathrow, LLC | Dentist | Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 | 2020-02-10 |
| 1376185876 | Rinehart Road Surgery Center, LLC | Clinic/Center | 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 | 2019-10-16 |
| 1871140988 | Central Florida Wellness LLC | General Practice | 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 | 2019-08-22 |
| 1326609942 | Antoine Slade I | Behavior Technician | 4876 Rhinehart Road, Lake Mary, FL 32746 | 2019-06-25 |
| 1245891209 | Ohri, LLC | Clinic/Center | 392 Rinehart Rd., Suite 1300, Lake Mary, FL 32746 | 2019-06-21 |
| 1336610856 | Olivia Laurel Stolz | Physician Assistant | 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 | 2018-12-10 |
| 1881171072 | Elite-star Medical Transport LLC. | Non-emergency Medical Transport (VAN) | 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 | 2018-07-20 |
| 1508351537 | Ariagny Elena Fereira | Speech-Language Pathologist | 145 Middle Street Suite 1101, Lake Mary, FL 32746 | 2018-06-22 |
| Find all providers in zip 32746 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417104779 | Jiby Oommen George | Pediatrics | 735 Primera Blvd Ste 135, Lake Mary, FL 32746-2149 | 2008-08-19 |
| 1902067879 | Sunstate Pediatrics | Pediatrics | 758 N Sun Dr Ste 108, Lake Mary, FL 32746-2599 | 2008-06-23 |
| 1750549523 | Powers Pediatrics | Pediatrics | 805 Silversmith Cir, Lake Mary, FL 32746-4911 | 2008-05-29 |
| 1821163635 | Shakuntala Janwadkar, Md, Pa | Pediatrics | 185 Waymont Ct, Suite 111, Lake Mary, FL 32746-6700 | 2006-11-21 |
| 1730262015 | Fatai Gbolade Adamson | Pediatrics | 1229 Sebastian Cv, Lake Mary, FL 32746-1954 | 2006-10-23 |
| 1093706095 | Mitchell W. Madden | Pediatrics | 725 Rodel Cv, Lake Mary, FL 32746-4859 | 2005-10-31 |
| 1588650576 | Ehteram Raissi-fard | Pediatrics | 758 N Sun Dr, Lake Mary, FL 32746-2599 | 2005-09-23 |
| 1568825768 | Alexa Rae Heller | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746 | 2016-04-04 |
| 1992142426 | Analise Paige Casey | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2013-05-23 |
| 1184941155 | Sarah C Li | Pediatrics | 410 Waymont Ct, Lake Mary, FL 32746-3485 | 2010-04-29 |
| Find all providers in LAKE MARY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.