Provider Demographics
NPI:1578710919
Name:ROLANDO AMADEO MDPA
Entity Type:Organization
Organization Name:ROLANDO AMADEO MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-740-8848
Mailing Address - Street 1:668 N ORLANDO AVE
Mailing Address - Street 2:1010
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4473
Mailing Address - Country:US
Mailing Address - Phone:407-740-8848
Mailing Address - Fax:407-740-0324
Practice Address - Street 1:668 N ORLANDO AVE
Practice Address - Street 2:1010
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4473
Practice Address - Country:US
Practice Address - Phone:407-740-8848
Practice Address - Fax:407-740-0324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty