1598925059 NPI number — MRS. MARIE MARANNE MONROE MSW

Table of content: MRS. MARIE MARANNE MONROE MSW (NPI 1598925059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598925059 NPI number — MRS. MARIE MARANNE MONROE MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONROE
Provider First Name:
MARIE
Provider Middle Name:
MARANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1598925059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 NE 25TH AVE
Provider Second Line Business Mailing Address:
SUITE 306
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34470-8800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-671-7884
Provider Business Mailing Address Fax Number:
352-671-7379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 NE 25TH AVE
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34470-8800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-671-7884
Provider Business Practice Location Address Fax Number:
352-671-7379
Provider Enumeration Date:
06/09/2008

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: 104100000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 767966100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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