Healthcare Provider Details

I. General information

NPI: 1619866621
Provider Name (Legal Business Name): BAILEY TRONCOSO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 E ROLLINS ST STE 4700
ORLANDO FL
32804-5534
US

IV. Provider business mailing address

201 MAITLAND AVE STE 1017
ALTAMONTE SPRINGS FL
32701-4903
US

V. Phone/Fax

Practice location:
  • Phone: 407-652-7043
  • Fax: 407-652-7044
Mailing address:
  • Phone: 407-885-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11037268
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberAPRN11037268
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: