Provider Demographics
NPI:1982770749
Name:RICHARDSON, RONDA (RPH)
Entity Type:Individual
Prefix:MS
First Name:RONDA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 COURTNEY CHASE CIR
Mailing Address - Street 2:#1123
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8158
Mailing Address - Country:US
Mailing Address - Phone:321-945-8339
Mailing Address - Fax:866-566-8434
Practice Address - Street 1:2050 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34743-8602
Practice Address - Country:US
Practice Address - Phone:407-348-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38155183500000X
TX37957183500000X
MI5302026984183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist