Ronderos Aesthetics, LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

20619 Issued in AL

Legal business name

RONDEROS AESTHETICS, LLC

Practice address

1132 Hillcrest Rd
Mobile, AL 36695-3920

Phone

(251) 776-1380

Fax

(251) 776-1381

NPI assigned

Nov 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer K Ronderos, M.D.

Title

M.D./Owner

Phone

(251) 776-1380

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Skin Perfection Med Spa Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1376725887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 HILLCREST RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366953920",
            "telephone_number": "251-776-1380",
            "fax_number": "251-776-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 HILLCREST RD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366953920",
            "telephone_number": "251-776-1380",
            "fax_number": "251-776-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONDEROS AESTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "RONDEROS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "251-776-1380",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AL",
            "license": "20619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AL",
            "identifier": "51544969",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skin Perfection Med Spa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha Rolling, RBT
• Quimara Romain, NP
• Kimberly Waynette Roman, MD
• Andrew Kessler Romeo, M.D.
• Ronald McDonald House Charities of Mobile, Inc.
• Angela Roney, M.S., LPC
• Lakeshia Seneitha Roper
• Hunter Lee Carmon Rosamond, RBT
• Rose Counseling Center
• Amanda A. Rose, CRSS

• Procedural Dermatology Physician in Mobile, AL
• Providers in Mobile, AL by specialty
• Procedural Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.