Provider Demographics
NPI:1033277272
Name:MONSON, JUDITH ANNE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANNE
Last Name:MONSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3269 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-4701
Mailing Address - Country:US
Mailing Address - Phone:941-587-8020
Mailing Address - Fax:941-952-1667
Practice Address - Street 1:3148 SOUTHGATE CIRCLE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-587-8020
Practice Address - Fax:941-952-1667
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA28676225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC-8968OtherBLUE CROSS BLUE SHEILD