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NPI Code Detail

MEDICARE: MONIQUE GULLO MSW

MEDICARE: MONIQUE GULLO MSW
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
11041C0700XClinical Social WorkerISW20970FL

General Provider Information

NPI Number : 1841123874
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE GULLO MSW
Provider Business Mailing Address
First Line : 5776 SAINT AUGUSTINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8046
Country : US
Telephone Number : 904-448-4700
Fax Number : 904-448-4717
Provider Business Practice Location Address
First Line : 5776 SAINT AUGUSTINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8046
Country : US
Telephone Number : 904-448-4700
Fax Number : 904-448-4717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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