Healthcare Provider Details

I. General information

NPI: 1841172764
Provider Name (Legal Business Name): ASTRID ROSADO-MULERO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 BUENAVENTURA BLVD
KISSIMMEE FL
34743-8128
US

IV. Provider business mailing address

790 BUENAVENTURA BLVD
KISSIMMEE FL
34743-8128
US

V. Phone/Fax

Practice location:
  • Phone: 407-348-0990
  • Fax: 407-944-9041
Mailing address:
  • Phone: 407-348-0990
  • Fax: 407-944-9041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9120611
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: