Healthcare Provider Details

I. General information

NPI: 1487375291
Provider Name (Legal Business Name): ROLAN OCCENA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 SAWGRASS CORPORATE PKWY STE 200
SUNRISE FL
33323-2869
US

IV. Provider business mailing address

1580 SAWGRASS CORPORATE PKWY STE 200
SUNRISE FL
33323-2869
US

V. Phone/Fax

Practice location:
  • Phone: 475-236-2047
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number011950
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: