Provider Demographics
NPI:1588226575
Name:ROTONDO, DEAN JOHN II (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:JOHN
Last Name:ROTONDO
Suffix:II
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6073 BALBOA CIR APT 206
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8162
Mailing Address - Country:US
Mailing Address - Phone:561-703-5964
Mailing Address - Fax:
Practice Address - Street 1:4600 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6600
Practice Address - Country:US
Practice Address - Phone:561-496-1094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10492103T00000X
FL10492103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist