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NPI Code Detail

MEDICARE: OBDULIA DOLORES RONDON D.M.D

MEDICARE: OBDULIA DOLORES RONDON D.M.D
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
11223G0001XGeneral Practice DentistryDN16435FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346346939
Entity Type Code : Individual
Provider Name (Legal Business Name) : OBDULIA DOLORES RONDON D.M.D
Provider Business Mailing Address
First Line : 7030 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-6206
Country : US
Telephone Number : 904-613-3375
Fax Number :
Provider Business Practice Location Address
First Line : 7030 NORMANDY BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-6206
Country : US
Telephone Number : 904-786-5850
Fax Number : 904-786-3101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 04/11/2018

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