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General NPI Number Information
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NPI Number | 1780604520
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Entity Type | Organization
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Legal Business Name | VILLAGE HEALTH ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4942 US HIGHWAY 98 W SUITE 15
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-4091
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Country | US
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Telephone | 850-622-0333
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Fax | 850-622-1333
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Provider Business Mailing Address
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Address Line | 4942 US HIGHWAY 98 W SUITE 15
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-4091
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Country | US
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Telephone | 850-622-0333
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Fax | 850-622-1333
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOSEPH P MONASTERO
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Credential | MD
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Telephone | 850-622-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME44019
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License Number State | FL
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