=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083823447
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MONICA MARIE COMPANIONI M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2007
-----------------------------------------------------
Last Update Date | 05/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 NW 179TH AVE STE 104
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-2819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-233-1555
-----------------------------------------------------
Fax | 954-374-9481
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 NW 179TH AVE STE 104
-----------------------------------------------------
City | PEMBROKE PINES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33029-2819
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-233-1555
-----------------------------------------------------
Fax | 954-374-9481
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | ME105583
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------