MR. DERICK DANVIL ROACHE (NPI# 1770663478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770663478 |
| Entity Type | Individual |
| Full Name | MR. DERICK DANVIL ROACHE |
| Credential | RN LCSW PSYD |
| Practice Address |
1201 First Street South Winter Haven FL 33880 |
| Mailing Address |
200 Avenue F North East Winter Haven FL 33881 |
| Practice Telephone | 8632971702 |
| Practice Fax Number | 8632916084 |
| Mailing Telephone | 8632931121 |
| Mailing Fax Number | 8632916084 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN9178432 | FL | Nursing Service Providers |
| Street Address |
1201 FIRST STREET SOUTH |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942217492 | George Winny | Psychiatry & Neurology | 1201 First Street South, Winter Haven, FL 33880 | 2006-08-01 |
| 1821262445 | Sharlene Lynette Pyatt | Case Manager/Care Coordinator | 1201 First Street South, Winter Haven, FL 33880 | 2008-04-15 |
| 1760654610 | Rachel Lauren Bartley | Case Manager/Care Coordinator | 1201 First Street South, Winter Haven, FL 33880 | 2008-04-01 |
| 1841462793 | Stephanie Lauren Osteen | Case Manager/Care Coordinator | 1201 First Street South, Winter Haven, FL 33880 | 2008-04-01 |
| 1669656989 | Connie Lynn Ogletree | Case Manager/Care Coordinator | 1201 First Street South, Winter Haven, FL 33881 | 2007-12-21 |
| 1629100979 | Cynthia D Haynes | Licensed Practical Nurse | 1201 First Street South, Winter Haven Hospital Inc Behavioral Health Division, Winter Haven, IL 33880 | 2007-03-12 |
| 1376617431 | Amber Kay Westall | Licensed Practical Nurse | 1201 First Street South, Winter Haven, FL 33880 | 2006-11-20 |
| 1750455754 | Carolyn Denise Carter | Licensed Practical Nurse | 1201 First Street South, Winter Haven, FL 33880 | 2006-11-20 |
| 1447333174 | Maureen Mcintire | Case Manager/Care Coordinator | 1201 First Street South, Winter Haven, FL 33880 | 2006-10-24 |
| 1942380639 | Marilyn Vaughn Waldron | Registered Nurse | 1201 First Street South, Winter Haven, FL 33880 | 2006-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851896955 | Cheryl Gonzalez | Physical Therapy Assistant | 1601 6th Street Swe, Winter Haven, FL 33880 | 2018-03-29 |
| 1265950661 | Integrity Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 135 1st Street South, Winter Haven, FL 33880 | 2017-09-06 |
| 1912423427 | Stacy Lewis | Counselor | 1943 Ave E Sw, Winter Haven, FL 33880 | 2017-08-16 |
| 1497275952 | Kleine Pediatrics | Pediatrics | 375 E Central Avenue, Suite 391, Winter Haven, FL 33880 | 2017-06-26 |
| 1255851457 | Farah N Habib | Dentist | 375 E Central Ave, Suite 361, Winter Haven, FL 33880 | 2017-06-20 |
| 1356878086 | Congruent Hearts Companions | Home Health | 111 Ave R N.e., Winter, FL 33880 | 2017-05-12 |
| 1689033201 | Jason Acosta | General Practice | 111 Avenue A Se, Winter Haven, FL 33880 | 2016-02-11 |
| 1629440573 | National Vision, Inc. | Technician/Technologist | 341 & 343 Cypress Gardens Blvd, Winter Haven, FL 33880 | 2015-10-30 |
| 1518336825 | Nicole A. Domenech | General Practice | 950 First St. South, Winter Haven, FL 33880 | 2015-09-16 |
| 1447666417 | Lee Tramell Vickers | Pharmacist | 701 1st Street, Winter Haven, FL 33880 | 2014-07-10 |
| Find all providers in zip 33880 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942380639 | Marilyn Vaughn Waldron | Registered Nurse | 1201 First Street South, Winter Haven, FL 33880 | 2006-10-16 |
| 1699873034 | Lola Joyce Stringfellow | Registered Nurse | 1201 1st St S, Winter Haven, FL 33880 | 2006-09-20 |
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|---|---|---|---|---|
| 1669073474 | Charmaine A. Byrd | Registered Nurse | 214 Se Victoria Gln, Lake City, FL 32025-9308 | 2020-11-06 |
| 1447851076 | Robert James Dickinson | Registered Nurse | 303 Ravenswood Dr, Saint Augustine, FL 32084-3047 | 2020-11-02 |
| 1922616275 | Tasia Nadine Porter | Registered Nurse | 652 Ne 121st St, Biscayne Park, FL 33161-5510 | 2020-07-22 |
| 1801421714 | Daniel B Wright Np-c | Registered Nurse | 140 Island Way Unit 127, Clearwater, FL 33767-2216 | 2020-03-11 |
| 1891339099 | Shakila Moore | Registered Nurse | 29910 State Road 56, Wesley Chapel, FL 33543-8800 | 2019-10-30 |
| 1578118113 | Kerry Elizabeth Mattos | Registered Nurse | 5150 Central Sarasota Pkwy Apt 209, Sarasota, FL 34238-7623 | 2019-08-08 |
| 1588122386 | Janile Nelson | Registered Nurse | 1525 Sw Iffla Ave, Port St Lucie, FL 34953-6538 | 2019-03-11 |
| 1780141986 | Catherine Elaine Riley | Registered Nurse | 2130 Hopkins St, Orange Park, FL 32073-5220 | 2019-02-23 |
| 1205301942 | Phoenix Rehab Center Corp | Registered Nurse | 8500 W Flagler St Ste 106, Miami, FL 33144-2063 | 2018-10-09 |
| 1306352570 | Nikita L Jenkins | Registered Nurse | 1410 Ne 219th St, Lawtey, FL 32058-4387 | 2017-12-22 |
| Find all providers with the same taxonomy | ||||
| City | WINTER HAVEN |
| Zip Code | 33880 |
Please comment or provide details below to improve the information on MR. DERICK DANVIL ROACHE.
| 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.