Healthcare Provider Details

I. General information

NPI: 1235851478
Provider Name (Legal Business Name): ISABELLA RONDAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12901 BRUCE B DOWNS BLVD
TAMPA FL
33612-4799
US

IV. Provider business mailing address

250 NW 76TH DR
GAINESVILLE FL
32607-6668
US

V. Phone/Fax

Practice location:
  • Phone: 813-974-8926
  • Fax:
Mailing address:
  • Phone: 352-505-6363
  • Fax: 352-505-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: