Provider Demographics
NPI:1003683681
Name:MONCADA, IVONELIA (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:IVONELIA
Middle Name:
Last Name:MONCADA
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 EXECUTIVE PARK DR STE 103
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3653
Mailing Address - Country:US
Mailing Address - Phone:954-530-8756
Mailing Address - Fax:
Practice Address - Street 1:2751 EXECUTIVE PARK DR STE 103
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3653
Practice Address - Country:US
Practice Address - Phone:954-530-8756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily