Provider Demographics
NPI:1043555030
Name:MONDIA, ANA RICA R (RPT)
Entity Type:Individual
Prefix:MRS
First Name:ANA RICA
Middle Name:R
Last Name:MONDIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:ANA RICA
Other - Middle Name:L
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8609 BRADLEYS LANDING ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6909
Mailing Address - Country:US
Mailing Address - Phone:203-731-0366
Mailing Address - Fax:
Practice Address - Street 1:7015 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5056
Practice Address - Country:US
Practice Address - Phone:203-731-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007919225100000X
FL39385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist