MEDICARE: MONROE JAMES KING DO

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	207K00000X	Allergy & Immunology Physician	OS0003842	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780643486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONROE JAMES KING DO

Provider Business Mailing Address
First Line	:	11200 SEMINOLE BLVD
Second Line	:	SUITE 310
City	:	LARGO
State	:	FL
Zip	:	33778-3239
Country	:	US
Telephone Number	:	727-397-8557
Fax Number	:	727-397-4459

Provider Business Practice Location Address
First Line	:	11200 SEMINOLE BLVD
Second Line	:	SUITE 310
City	:	LARGO
State	:	FL
Zip	:	33778-3239
Country	:	US
Telephone Number	:	727-397-8557
Fax Number	:	727-397-4459

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	01/26/2015

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Directions to “ MONROE JAMES KING DO” Practice Location

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