Provider Demographics
NPI:1528580412
Name:RONDON MORA, YASBELI
Entity Type:Individual
Prefix:
First Name:YASBELI
Middle Name:
Last Name:RONDON MORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11575 CITY HALL PROMENADE UNIT 340
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7593
Mailing Address - Country:US
Mailing Address - Phone:786-317-7081
Mailing Address - Fax:
Practice Address - Street 1:11575 CITY HALL PROMENADE UNIT 340
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7593
Practice Address - Country:US
Practice Address - Phone:786-317-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-49333103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst