Healthcare Provider Details

I. General information

NPI: 1619377439
Provider Name (Legal Business Name): ROLANDO URGELLES DEL TORO FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROLANDO URGELLES

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MAITLAND CENTER PKWY STE 310
MAITLAND FL
32751-7442
US

IV. Provider business mailing address

2400 MAITLAND CENTER PKWY STE 310
MAITLAND FL
32751-7442
US

V. Phone/Fax

Practice location:
  • Phone: 407-426-4800
  • Fax: 407-426-4820
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11008864
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11008864
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9117761
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: