Healthcare Provider Details

I. General information

NPI: 1447432836
Provider Name (Legal Business Name): PAGSHUWA MONIQUE WASHINGTON M.ED, RDCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 BROKEN SOUND PKWY STE 500
BOCA RATON FL
33487-2791
US

IV. Provider business mailing address

1431 ATTAKAPAS DR
OPELOUSAS LA
70570-6558
US

V. Phone/Fax

Practice location:
  • Phone: 800-875-8999
  • Fax: 561-417-7443
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number116054
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: