Provider Demographics
NPI:1265444335
Name:ESTRADA, ROLANDO
Entity type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:ROLAND
Other - Middle Name:
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:70 PROVIDENCE PL STE 8
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1747
Mailing Address - Country:US
Mailing Address - Phone:401-243-0685
Mailing Address - Fax:401-243-0683
Practice Address - Street 1:70 PROVIDENCE PL
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1747
Practice Address - Country:US
Practice Address - Phone:401-243-0685
Practice Address - Fax:401-243-0683
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI0449152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI79864OtherBLUE CROSS
RI9007914Medicaid
RI2200320OtherUNITED HEALTH CARE
RI79864OtherBLUE CROSS