Healthcare Provider Details

I. General information

NPI: 1699517854
Provider Name (Legal Business Name): MONARCH PSYCHIATRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2024
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2523 HERSCHEL ST
JACKSONVILLE FL
32204-4509
US

IV. Provider business mailing address

644 MEADOWBROOK DR
WINTER SPRINGS FL
32708-2117
US

V. Phone/Fax

Practice location:
  • Phone: 407-617-0906
  • Fax: 407-612-1595
Mailing address:
  • Phone: 407-917-5073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD LAZARUS
Title or Position: OWNER
Credential: PMHNP
Phone: 407-917-5073