Individual
LARA DONDERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
951 N WASHINGTON AVE BLDG 4, TITUSVILLE, FL 32796-2194
(321) 684-0187
Mailing address
6548 WINDOVER WAY, TITUSVILLE, FL 32780-7565
(321) 684-0187
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29667
FL
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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