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General NPI Number Information
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NPI Number | 1104613256
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Entity Type | Organization
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Legal Business Name | MONARCH HOLISTIC & WELLNESS SERVICES, LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 8751 W BROWARD BLVD STE 106
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City | PLANTATION
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State | FL
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Zip | 33324-2630
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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 | 4857 NW 67TH AVE
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City | LAUDERHILL
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State | FL
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Zip | 33319-7218
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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 ASSOCIATE
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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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