MEDICARE: MS. RONA BRIONES PERSZYK M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	IMH 5730	FL
2	101YM0800X	Mental Health Counselor	MH9550	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MH 9550	OTHER	FL	FLORIDA LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	IMH 5730	OTHER	FL	FLORIDA INTERN LICENSE

General Provider Information

NPI Number	:	1295883908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RONA BRIONES PERSZYK M.A.

Provider Business Mailing Address
First Line	:	165 WELLS RD STE 304
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-3037
Country	:	US
Telephone Number	:	904-720-4040
Fax Number	:	904-720-4596

Provider Business Practice Location Address
First Line	:	165 WELLS RD STE 304
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-3037
Country	:	US
Telephone Number	:	904-720-4040
Fax Number	:	904-720-4596

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	05/02/2024

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