MEDICARE: MAURICIO BERRIO OROZCO NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	306583	NY
2	363LA2200X	Adult Health Nurse Practitioner	11005730	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QC331	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	APRN11005730	OTHER	FL	STATE MEDICAL LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063891893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAURICIO BERRIO OROZCO NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	16313 NEW INDEPENDENCE PKWY # 110
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-8113
Country	:	US
Telephone Number	:	407-593-4665
Fax Number	:	407-656-4591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	06/05/2025

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Directions to “ MAURICIO BERRIO OROZCO NURSE PRACTITIONER” Practice Location

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