1174967129 NPI number — MRS. MONICA CRISTINA BOVEE ATC, LAT, ROT

Table of content: MRS. MONICA CRISTINA BOVEE ATC, LAT, ROT (NPI 1174967129)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174967129 NPI number — MRS. MONICA CRISTINA BOVEE ATC, LAT, ROT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOVEE
Provider First Name:
MONICA
Provider Middle Name:
CRISTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ATC, LAT, ROT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174967129
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4800 S WESTSHORE BLVD
Provider Second Line Business Mailing Address:
APT # 521
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33611-3040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-470-5296
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 10TH ST N
Provider Second Line Business Practice Location Address:
SUITE 1D
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33705-1407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-894-1818
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  AL1855 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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