Healthcare Provider Details

I. General information

NPI: 1942711361
Provider Name (Legal Business Name): LAURA MONCADA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 N COCOA BLVD STE E-F
COCOA FL
32922-7590
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 321-522-4000
  • Fax: 844-388-6186
Mailing address:
  • Phone: 727-322-3439
  • Fax: 800-928-7449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9365567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: