Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY9794 | FL |
NPI | 1023556065 |
---|---|
Provider Name | Dr. Maria Jose Rendon |
First Address | Pembroke Pines, FL 33027-6130 |
Second Address | Pembroke Pines, FL 33027-6130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2017 |
Last Update Date | 22/05/2018 |