Individual
RAFAEL AUGUSTO RONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5331 PRIMROSE LAKE CIR STE 112, TAMPA, FL 33647-3764
(813) 517-4629
(813) 200-1036
Mailing address
5331 PRIMROSE LAKE CIR STE 112, TAMPA, FL 33647-3764
(813) 517-4629
(813) 200-1036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME100751
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
0101242340
VA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME100751
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AK669Z
MEDICARE
FL
01
—
AK669Z
MEDICARE
—
Enumeration date
06/18/2007
Last updated
01/21/2021
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