MEDICARE: MONA ISSA CHIROPRACTIC AND HOLISTIC CENTER

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	111N00000X	Chiropractor	CH8219	FL

General Provider Information

NPI Number	:	1619009925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONA ISSA CHIROPRACTIC AND HOLISTIC CENTER

Provider Business Mailing Address
First Line	:	701 LINCOLN RD
Second Line	:	#102
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2879
Country	:	US
Telephone Number	:	305-538-5448
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 LINCOLN RD
Second Line	:	#102
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2879
Country	:	US
Telephone Number	:	305-538-5448
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. MONA ISSA
Credential	:	D.C., P.A.
Telephone Number	:	305-538-5448

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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