Provider Demographics
NPI:1992412662
Name:OCEGUERA AMADOR, ROGELIO (FNP)
Entity type:Individual
Prefix:
First Name:ROGELIO
Middle Name:
Last Name:OCEGUERA AMADOR
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8433 N JONES AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-1019
Mailing Address - Country:US
Mailing Address - Phone:813-810-7323
Mailing Address - Fax:
Practice Address - Street 1:7555 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1511
Practice Address - Country:US
Practice Address - Phone:855-226-6633
Practice Address - Fax:888-481-1462
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily