Provider Demographics
NPI:1376294843
Name:CARBONELL RONDON, ANA EMILIA (BCBA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:EMILIA
Last Name:CARBONELL RONDON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 SW 48TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6654
Mailing Address - Country:US
Mailing Address - Phone:786-362-4495
Mailing Address - Fax:
Practice Address - Street 1:9035 SW 48TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-6654
Practice Address - Country:US
Practice Address - Phone:786-362-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-57310103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst