Provider Demographics
NPI:1891350831
Name:ROLON, MARIA (MSW, RCSW - INTERN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ROLON
Suffix:
Gender:F
Credentials:MSW, RCSW - INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 IVEL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6522
Mailing Address - Country:US
Mailing Address - Phone:787-477-4351
Mailing Address - Fax:
Practice Address - Street 1:1400 N SEMORAN BLVD STE E
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3562
Practice Address - Country:US
Practice Address - Phone:407-823-8421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW11530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE