Healthcare Provider Details

I. General information

NPI: 1588585723
Provider Name (Legal Business Name): MONICA DEOLIVEIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 NW 39TH AVE
DEERFIELD BEACH FL
33442-7344
US

IV. Provider business mailing address

673 NW 39TH AVE
DEERFIELD BEACH FL
33442-7344
US

V. Phone/Fax

Practice location:
  • Phone: 954-907-3730
  • Fax:
Mailing address:
  • Phone: 954-907-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA109774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: