Provider Demographics
NPI:1073958518
Name:RONDA-VELEZ, YAMILETTE (DPT)
Entity Type:Individual
Prefix:
First Name:YAMILETTE
Middle Name:
Last Name:RONDA-VELEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 BRONX PARK E APT C1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-7390
Mailing Address - Country:US
Mailing Address - Phone:646-281-5378
Mailing Address - Fax:
Practice Address - Street 1:2754 BRONX PARK E APT C1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-7390
Practice Address - Country:US
Practice Address - Phone:646-281-5378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28132225100000X
NY62 - 035089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist