Provider Demographics
NPI:1831664481
Name:LASANTA BONDY, ADRIANA (PHD)
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:LASANTA BONDY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5483 VINELAND RD APT 10203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7647
Mailing Address - Country:US
Mailing Address - Phone:787-633-5144
Mailing Address - Fax:
Practice Address - Street 1:5483 VINELAND RD APT 10203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7647
Practice Address - Country:US
Practice Address - Phone:787-633-5144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5816103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist