MEDICARE: MARIBEL E MONROE MD

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	207VX0201X	Gynecologic Oncology Physician	8642	NV
2	207VG0400X	Gynecology Physician	8642	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V103819	OTHER	NV	PTAN

General Provider Information

NPI Number	:	1396732988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL E MONROE MD

Provider Business Mailing Address
First Line	:	2480 PROFESSIONAL CT
Second Line	:	STE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0835
Country	:	US
Telephone Number	:	702-868-9100
Fax Number	:	702-868-9101

Provider Business Practice Location Address
First Line	:	2480 PROFESSIONAL CT
Second Line	:	STE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0835
Country	:	US
Telephone Number	:	702-868-9100
Fax Number	:	702-868-9101

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	01/03/2019

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Directions to “ MARIBEL E MONROE MD” Practice Location

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