MEDICARE: CHRISTIAN MONROE

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	124Q00000X	Dental Hygienist	32867	FL

General Provider Information

NPI Number	:	1710810486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN MONROE

Provider Business Mailing Address
First Line	:	17243 OLD TOBACCO RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-4947
Country	:	US
Telephone Number	:	813-442-1930
Fax Number	:

Provider Business Practice Location Address
First Line	:	17243 OLD TOBACCO RD
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-4947
Country	:	US
Telephone Number	:	813-442-1930
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ CHRISTIAN MONROE ” Practice Location

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