Healthcare Provider Details

I. General information

NPI: 1093455214
Provider Name (Legal Business Name): ANGELA FERNANDEZ MONOZN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W 76TH ST STE 211
HIALEAH FL
33016-5503
US

IV. Provider business mailing address

13879 SW 64TH ST
MIAMI FL
33183-1183
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-1287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH27396
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: