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NPI Code Detail

MEDICARE: MS. DIANA MONROE LCSW

MEDICARE: MS. DIANA MONROE LCSW
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
11041C0700XClinical Social WorkerSW5566FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SW5566OTHERFLPROFESSIONAL LICENSE

General Provider Information

NPI Number : 1639309024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA MONROE LCSW
Provider Business Mailing Address
First Line : 16100 S POST RD APT 202
Second Line :
City : WESTON
State : FL
Zip : 33331-3542
Country : US
Telephone Number : 754-281-2911
Fax Number : 239-332-4977
Provider Business Practice Location Address
First Line : 390 PONDELLA RD STE 9
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-4340
Country : US
Telephone Number : 239-652-0260
Fax Number : 239-652-0146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2009
Last Update Date : 09/22/2021

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