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General NPI Number Information
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NPI Number | 1689117657
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Entity Type | Individual
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Provider Name | EMILY R MONAHAN PA-C, ATC, OTC
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Gender | Female
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 2727 W DR MARTIN LUTHER KING JR BLVD SUITE 320
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City | TAMPA
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State | FL
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Zip | 33607-6383
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Country | US
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Telephone | 813-877-6748
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Fax | 813-875-0359
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Provider Business Mailing Address
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Address Line | 2727 W DR MARTIN LUTHER KING JR BLVD STE 320
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City | TAMPA
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State | FL
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Zip | 33607-6055
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Country | US
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Telephone | 813-877-6748
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Fax | 813-875-0359
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | AL 3279
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9110070
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License Number State | FL
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