Provider Demographics
NPI:1174490791
Name:SANT'ANNA RONDON, IARA SIMBERE
Entity type:Individual
Prefix:
First Name:IARA
Middle Name:SIMBERE
Last Name:SANT'ANNA RONDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IARA
Other - Middle Name:SIMBERE
Other - Last Name:SANT'ANNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11392 NW 87TH LN
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-5616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3580 NW 85TH CT APT 255
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1987
Practice Address - Country:US
Practice Address - Phone:301-979-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH25907101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health