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General NPI Number Information
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NPI Number | 1033729843
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Entity Type | Organization
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Legal Business Name | MONARCH MENTAL HEALTH & WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 08/06/2020
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 648 NW 183RD STREET
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-3331
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Country | US
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Telephone | 954-399-6004
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Fax | 954-206-0500
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Provider Business Mailing Address
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Address Line | 401 E LAS OLAS BLVD STE 130-146
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2210
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Country | US
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Telephone | 954-560-7124
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Fax | 954-206-0500
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MRS. CLAUDENIE MONDESIR
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Credential | PA-C
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Telephone | 954-560-7124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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