Provider Demographics
NPI:1487852869
Name:ANTOLIN, MONICA PATINO (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:PATINO
Last Name:ANTOLIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3944 LONG BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-4790
Mailing Address - Country:US
Mailing Address - Phone:407-889-0553
Mailing Address - Fax:407-889-0553
Practice Address - Street 1:6000 TURKEY LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4200
Practice Address - Country:US
Practice Address - Phone:407-649-1848
Practice Address - Fax:407-649-1979
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3280452363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily