Provider Demographics
NPI:1295883908
Name:PERSZYK, RONA BRIONES (MA)
Entity type:Individual
Prefix:MS
First Name:RONA
Middle Name:BRIONES
Last Name:PERSZYK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 WELLS RD STE 304
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-3037
Mailing Address - Country:US
Mailing Address - Phone:904-720-4040
Mailing Address - Fax:904-720-4596
Practice Address - Street 1:165 WELLS RD STE 304
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-3037
Practice Address - Country:US
Practice Address - Phone:904-720-4040
Practice Address - Fax:904-720-4596
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 5730101Y00000X
FLMH9550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 9550OtherFLORIDA LICENSE
FL7674252 00Medicaid
FLIMH 5730OtherFLORIDA INTERN LICENSE