Healthcare Provider Details

I. General information

NPI: 1568320125
Provider Name (Legal Business Name): ELCIO ROQUE KLEINPAUL SR. APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 E SEMORAN BLVD
APOPKA FL
32703-5713
US

IV. Provider business mailing address

12125 VIA CASELLI LN
WINDERMERE FL
34786-6834
US

V. Phone/Fax

Practice location:
  • Phone: 407-886-4878
  • Fax:
Mailing address:
  • Phone: 689-345-3636
  • Fax: 689-345-3636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11044848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: