Basic Information
| Provider Information | |||||||||
| NPI: | 1407407695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DEL PILAR | ||||||||
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| Credential: | MSN, APRN, FNP-C, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4585 SAN FRATELLO CIR | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334675074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612273993 | ||||||||
| FaxNumber: | 5618554308 | ||||||||
| Practice Location | |||||||||
| Address1: | 330 S DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334604400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5612273993 | ||||||||
| FaxNumber: | 5618554308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2019 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 9496864 | FL | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 11004606 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.