Healthcare Provider Details
I. General information
NPI: 1033593736
Provider Name (Legal Business Name): MONIC MENARD ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2061 ENGLEWOOD RD SUITE 4
ENGLEWOOD FL
34223-1749
US
IV. Provider business mailing address
2061 ENGLEWOOD RD SUITE 4
ENGLEWOOD FL
34223-1749
US
V. Phone/Fax
- Phone: 941-473-8881
- Fax: 941-475-0801
- Phone: 941-473-8881
- Fax: 941-475-0801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP3201072 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: