Provider Demographics
NPI:1467094912
Name:XMINIS, MONET
Entity Type:Individual
Prefix:
First Name:MONET
Middle Name:
Last Name:XMINIS
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 1:4690 NW 41ST PL
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4781
Mailing Address - Country:US
Mailing Address - Phone:965-607-0622
Mailing Address - Fax:
Practice Address - Street 1:4690 NW 41ST PL
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-4781
Practice Address - Country:US
Practice Address - Phone:954-607-0622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker