1962510289 NPI number — MR. MICHAEL H MONCARZ L. AP

Table of content: THANH KIM TRAN M.D. (NPI 1265453708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962510289 NPI number — MR. MICHAEL H MONCARZ L. AP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONCARZ
Provider First Name:
MICHAEL
Provider Middle Name:
H
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L. AP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONCARZ
Provider Other First Name:
MICHAEL
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1962510289
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16359 75TH PL N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOXAHATCHEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33470-3049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-370-9416
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 JUPITER LAKES BLVD
Provider Second Line Business Practice Location Address:
BUILDING 5000 SUITE #102
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-7191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-741-1876
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2006

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: 171100000X , with the licence number:  AP 1741 , 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)