Provider Demographics
NPI:1225224751
Name:RIOS-PONDER, TAMELA M (MT-BC)
Entity Type:Individual
Prefix:MISS
First Name:TAMELA
Middle Name:M
Last Name:RIOS-PONDER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 LEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-5621
Mailing Address - Country:US
Mailing Address - Phone:407-489-1783
Mailing Address - Fax:
Practice Address - Street 1:105 COMMERCE ST
Practice Address - Street 2:SUIT 109
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6228
Practice Address - Country:US
Practice Address - Phone:407-833-2729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist