Provider Demographics
NPI:1376080077
Name:ISIDRON, VERONICA (MSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ISIDRON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 W STATE ROAD 84
Mailing Address - Street 2:11-26
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3396
Mailing Address - Country:US
Mailing Address - Phone:954-333-8787
Mailing Address - Fax:954-333-8621
Practice Address - Street 1:1000 N HIATUS RD
Practice Address - Street 2:STE 161
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-333-8787
Practice Address - Fax:954-333-8621
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst