Healthcare Provider Details

I. General information

NPI: 1225386451
Provider Name (Legal Business Name): MONICA OGANES PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WINDERLEY PLACE SUITE 300
MAITLAND FL
32751-7133
US

IV. Provider business mailing address

555 WINDERLEY PLACE SUITE 300
MAITLAND FL
32751-7133
US

V. Phone/Fax

Practice location:
  • Phone: 407-809-5680
  • Fax: 407-809-5698
Mailing address:
  • Phone: 407-809-5680
  • Fax: 407-809-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number55931
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: