Provider Demographics
NPI:1073529434
Name:M & J MONACO PA
Entity Type:Organization
Organization Name:M & J MONACO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:MONACO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-263-6536
Mailing Address - Street 1:4142 MARINER BLVD STE 121
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2468
Mailing Address - Country:US
Mailing Address - Phone:813-263-6536
Mailing Address - Fax:813-741-3480
Practice Address - Street 1:6716 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653
Practice Address - Country:US
Practice Address - Phone:813-263-6536
Practice Address - Fax:813-741-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty