MEDICARE: MONICA URREA, M.D., LLC

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	207R00000X	Internal Medicine Physician	111309	FL

General Provider Information

NPI Number	:	1548690886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONICA URREA, M.D., LLC

Provider Business Mailing Address
First Line	:	5009 COUNTRY AIRE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-2010
Country	:	US
Telephone Number	:	813-956-3937
Fax Number	:	813-933-1061

Provider Business Practice Location Address
First Line	:	5009 COUNTRY AIRE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-2010
Country	:	US
Telephone Number	:	813-956-3937
Fax Number	:	813-933-1061

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MONICA URREA
Credential	:	M.D.
Telephone Number	:	813-956-3937

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	11/22/2013

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