Provider Demographics
NPI:1427072826
Name:GONDRA, MARIA PILAR (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:PILAR
Last Name:GONDRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BENEVENTO AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2014
Mailing Address - Country:US
Mailing Address - Phone:305-666-4347
Mailing Address - Fax:
Practice Address - Street 1:147 ALHAMBRA CIR STE 205
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4530
Practice Address - Country:US
Practice Address - Phone:305-648-0604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH004296101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health