Healthcare Provider Details

I. General information

NPI: 1720925225
Provider Name (Legal Business Name): YENY MONZON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 11TH AVE SW
LARGO FL
33770-7421
US

IV. Provider business mailing address

126 11TH AVE SW
LARGO FL
33770-7421
US

V. Phone/Fax

Practice location:
  • Phone: 678-768-6886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberNA
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: