Provider Demographics
NPI:1184663585
Name:MONZON, ANTONIO IV
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:MONZON
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-595-4070
Mailing Address - Fax:305-595-3526
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:SUITE 302
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2144
Practice Address - Country:US
Practice Address - Phone:305-595-4070
Practice Address - Fax:305-595-3526
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54479207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374572400Medicaid
FL08801Medicare ID - Type Unspecified
FL374572400Medicaid