Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP9368135 | FL |
N | 363LG0600X | Nurse Practitioner - Gerontology | ARNP9368135 | FL |
NPI | 1073000436 |
---|---|
Provider Name | Mr. Roldig De La Orden |
First Address | Miami, FL 33183-3253 |
Second Address | Miami, FL 33183-3253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2018 |
Last Update Date | 20/04/2018 |