Provider Demographics
NPI:1114938040
Name:MONICO, BRIAN DAVID I (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:DAVID
Last Name:MONICO
Suffix:I
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BRICKELL KEY BLVD APT 1111
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2678
Mailing Address - Country:US
Mailing Address - Phone:786-405-9304
Mailing Address - Fax:888-264-0304
Practice Address - Street 1:701 BRICKELL KEY BLVD APT 1111
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2678
Practice Address - Country:US
Practice Address - Phone:786-405-9304
Practice Address - Fax:888-264-0304
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891631400Medicaid