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Provider Information for 1649801523


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ELLEN RONDINO LMFT


Sex: Female

NPI: 1649801523
Last Updated: 2020-01-30
Certification Date: 2020-01-30

Details

NameValue
NPI1649801523
Enumeration Date2020-01-30
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 5807 NW 70TH AVE
TAMARAC, FL 33321-5700
United States

Phone: | Fax:
 
Primary Practice Address 11011 SHERIDAN STREET
SUITE 211
COPPER CITY, FL 33026
United States

Phone: 954-951-2929 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 106H00000X - Marriage & Family Therapist