MEDICARE: VILLAGE HEALTH ASSOCIATES, 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	261Q00000X	Clinic/Center	ME44019	FL

General Provider Information

NPI Number	:	1780604520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE HEALTH ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	4942 US HIGHWAY 98 W
Second Line	:	SUITE 15
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-4091
Country	:	US
Telephone Number	:	850-622-0333
Fax Number	:	850-622-1333

Provider Business Practice Location Address
First Line	:	4942 US HIGHWAY 98 W
Second Line	:	SUITE 15
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-4091
Country	:	US
Telephone Number	:	850-622-0333
Fax Number	:	850-622-1333

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. JOSEPH P MONASTERO
Credential	:	MD
Telephone Number	:	850-622-0333

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/22/2020

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