Active NPI
Roberto Carlos Azocar Perozo Sr., SA
- Surgical Assistant
- Orlando, FL
National Provider Identifier
1639969041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 22-603
- Practice address
- 9751 Mountain Lake Dr
Orlando, FL 32832-5999 - Phone
- (786) 395-4391
- NPI assigned
- May 8, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 22-603 | WI | Primary |
Addresses
Primary practice location
9751 Mountain Lake Dr
Orlando, FL 32832-5999
Mailing address
9751 Mountain Lake Dr
Orlando, FL 32832-5999
Phone (786) 395-4391
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22-603 | WI | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1639969041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9751 MOUNTAIN LAKE DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328325999",
"telephone_number": "786-395-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9751 MOUNTAIN LAKE DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328325999",
"telephone_number": "786-395-4391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZOCAR PEROZO",
"first_name": "ROBERTO",
"middle_name": "CARLOS",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "SA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-08",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "WI",
"license": "22-603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.