Healthcare Provider Details

I. General information

NPI: 1508258625
Provider Name (Legal Business Name): MONIKA BRIDGET PLATA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13121 OLIO RD STE 300
FISHERS IN
46037-7240
US

IV. Provider business mailing address

13121 OLIO RD STE 300
FISHERS IN
46037-7240
US

V. Phone/Fax

Practice location:
  • Phone: 317-355-6910
  • Fax: 317-621-1310
Mailing address:
  • Phone: 317-355-6910
  • Fax: 317-621-1310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26020003A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number26020003A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: