Provider Demographics
NPI:1427366897
Name:QUILES, MONICA A (LMT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:QUILES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6803
Mailing Address - Country:US
Mailing Address - Phone:407-420-2199
Mailing Address - Fax:
Practice Address - Street 1:921 TOWN CENTER DR
Practice Address - Street 2:STE 300
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8311
Practice Address - Country:US
Practice Address - Phone:386-774-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA47933225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist