Healthcare Provider Details

I. General information

NPI: 1578473195
Provider Name (Legal Business Name): YOLANDA KARINA MONCADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 CARGAN PARK AVENUE
CLERMONT FL
34714
US

IV. Provider business mailing address

609 KINGS RIDGE LOOP
DAVENPORT FL
33897-7546
US

V. Phone/Fax

Practice location:
  • Phone: 407-723-6402
  • Fax:
Mailing address:
  • Phone: 407-723-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA100710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: