Healthcare Provider Details

I. General information

NPI: 1912181447
Provider Name (Legal Business Name): MONICA P ILIEVSKI ARNP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8621 SW 87TH CT
MIAMI FL
33173-4553
US

IV. Provider business mailing address

8621 SW 87TH CT
MIAMI FL
33173-4553
US

V. Phone/Fax

Practice location:
  • Phone: 786-573-3397
  • Fax: 786-573-3397
Mailing address:
  • Phone: 786-573-3397
  • Fax: 786-573-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number3015172
License Number StateFL

VIII. Authorized Official

Name: MONICA P ILIEVSKI
Title or Position: PRESIDENT
Credential: ARNP
Phone: 786-573-3397