Provider Demographics
NPI:1073136354
Name:CAPOVANI, MONICA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:CAPOVANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 RENAISSANCE COMMONS BLVD APT 317
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8295
Mailing Address - Country:US
Mailing Address - Phone:786-348-5699
Mailing Address - Fax:
Practice Address - Street 1:601 N CONGRESS AVE STE 420
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4640
Practice Address - Country:US
Practice Address - Phone:561-499-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10337103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty