Provider Demographics
NPI:1023828258
Name:BLONDER, KAZUMASA Y
Entity type:Individual
Prefix:MR
First Name:KAZUMASA
Middle Name:Y
Last Name:BLONDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 ALTAMONTE BAY CLUB CIR APT 205
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5800
Mailing Address - Country:US
Mailing Address - Phone:413-310-1184
Mailing Address - Fax:
Practice Address - Street 1:907 OUTER ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6601
Practice Address - Country:US
Practice Address - Phone:413-310-1184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician