MEDICARE: CLARA MONFORT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1477931434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARA MONFORT

Provider Business Mailing Address
First Line	:	5400 S UNIVERSITY DR STE 118
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-5309
Country	:	US
Telephone Number	:	954-893-9499
Fax Number	:

Provider Business Practice Location Address
First Line	:	5400 S UNIVERSITY DR STE 118
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-5309
Country	:	US
Telephone Number	:	954-893-9499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/11/2015

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Directions to “ CLARA MONFORT ” Practice Location

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