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General NPI Number Information
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NPI Number | 1053869529
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Entity Type | Individual
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Provider Name | EBONY MONIQUE ROLLINS ARNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 130 BATES AVE SW STE 111
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City | WINTER HAVEN
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State | FL
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Zip | 33880-2920
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Country | US
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Telephone | 863-268-4626
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Fax | 866-825-5809
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Provider Business Mailing Address
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Address Line | 130 BATES AVE SW STE 111
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City | WINTER HAVEN
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State | FL
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Zip | 33880-2920
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Country | US
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Telephone | 863-268-4626
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Fax | 866-825-5809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9304982
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9304982
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License Number State | FL
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