MEDICARE: DR. JOHN V. MONSOUR LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 0001384	FL

General Provider Information

NPI Number	:	1093901043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN V. MONSOUR LMHC

Provider Business Mailing Address
First Line	:	2604 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4106
Country	:	US
Telephone Number	:	813-872-7186
Fax Number	:

Provider Business Practice Location Address
First Line	:	2604 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4106
Country	:	US
Telephone Number	:	813-872-7186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2007
Last Update Date	:	09/23/2007

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