Healthcare Provider Details

I. General information

NPI: 1699808808
Provider Name (Legal Business Name): JENNIFER CATHERINE MONROE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 NW 11TH AVE
BOCA RATON FL
33486-3452
US

IV. Provider business mailing address

399 NW 11TH AVE
BOCA RATON FL
33486-3452
US

V. Phone/Fax

Practice location:
  • Phone: 561-441-5829
  • Fax:
Mailing address:
  • Phone: 561-441-5829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberFL 96213
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: