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General NPI Number Information
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NPI Number | 1952433260
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Entity Type | Individual
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Provider Name | MONA ISSA D.C., P.A.
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11200 PINES BLVD #101
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4139
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Country | US
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Telephone | 786-267-0771
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Fax |
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Provider Business Mailing Address
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Address Line | 11200 PINES BLVD #101
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-4139
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Country | US
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Telephone | 786-267-0771
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8219
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License Number State | FL
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