Provider Demographics
NPI:1023418415
Name:FUNES, ROLAND (M ED)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:FUNES
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 BELLA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6387
Mailing Address - Country:US
Mailing Address - Phone:407-455-4886
Mailing Address - Fax:
Practice Address - Street 1:933 BELLA VISTA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6387
Practice Address - Country:US
Practice Address - Phone:407-455-4886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor