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1568667715

NPI Code Detail

MEDICARE: RAFAEL AUGUSTO RONDON MD

MEDICARE: RAFAEL AUGUSTO RONDON MD

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	207R00000X	Internal Medicine Physician	ME100751	FL
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	0101242340	VA
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	ME100751	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AK669Z	OTHER		MEDICARE
2	AK669Z	OTHER	FL	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1568667715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL AUGUSTO RONDON MD

Provider Business Mailing Address
First Line	:	5331 PRIMROSE LAKE CIR STE 112
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3764
Country	:	US
Telephone Number	:	813-517-4629
Fax Number	:	813-200-1036

Provider Business Practice Location Address
First Line	:	5331 PRIMROSE LAKE CIR STE 112
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3764
Country	:	US
Telephone Number	:	813-517-4629
Fax Number	:	813-200-1036

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	01/21/2021

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Directions to “ RAFAEL AUGUSTO RONDON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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