Provider Demographics
NPI:1194040410
Name:MONAGAS, MARIOLA (MD)
Entity Type:Individual
Prefix:
First Name:MARIOLA
Middle Name:
Last Name:MONAGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CALLE JOSE DE DIEGO
Mailing Address - Street 2:CLUB MANOR
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-5175
Mailing Address - Country:US
Mailing Address - Phone:787-882-7766
Mailing Address - Fax:787-882-6373
Practice Address - Street 1:1213 CALLE TOMAS AGRAIT
Practice Address - Street 2:CLUB MANOR
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-4333
Practice Address - Country:US
Practice Address - Phone:787-614-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18530207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology