Provider Demographics
NPI:1356817662
Name:OROZCO CANTILLO, MONICA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:OROZCO CANTILLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12920 SW 108 PLACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1435
Mailing Address - Country:US
Mailing Address - Phone:786-404-1599
Mailing Address - Fax:443-456-4211
Practice Address - Street 1:12651 S DIXIE HWY STE 311
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5961
Practice Address - Country:US
Practice Address - Phone:786-404-1599
Practice Address - Fax:443-456-4211
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9263561207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine