Provider Demographics
NPI:1013910314
Name:AMADEO, ROLANDO (MD)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:AMADEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 N ORLANDO AVE
Mailing Address - Street 2:SUITE 1005
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:SUITE 1005
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0077114208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46242OtherBCBS
FL5035771001OtherCIGNA
FL032763OtherNEIGHBORHOOD HEALTH
FL269835OtherAVMED
FL2332362OtherAETNA PPO
FL2351409OtherAETNA HMO
FL032763OtherNEIGHBORHOOD HEALTH
FL46242ZMedicare ID - Type Unspecified