MEDICARE: MRS. AMANDA KAY MONKOSKI LDO

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	156FX1800X	Optician	DO6846	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

General Provider Information

NPI Number	:	1871292177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA KAY MONKOSKI LDO

Provider Business Mailing Address
First Line	:	549 HICKORY DR
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8776
Country	:	US
Telephone Number	:	904-431-9882
Fax Number	:

Provider Business Practice Location Address
First Line	:	549 HICKORY DR
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-8776
Country	:	US
Telephone Number	:	904-431-9882
Fax Number	:

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

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	02/27/2023

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