Provider Demographics
NPI:1427607142
Name:RODRIGUEZ MEDEROS, MONIKA
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:RODRIGUEZ MEDEROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 NW 36TH ST STE 411
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6964
Mailing Address - Country:US
Mailing Address - Phone:786-522-7203
Mailing Address - Fax:786-522-7204
Practice Address - Street 1:6501 NW 36TH ST STE 411
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6964
Practice Address - Country:US
Practice Address - Phone:786-522-7203
Practice Address - Fax:786-522-7204
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management