Provider Demographics
NPI:1508885286
Name:MONZON, RAUL A (MD)
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:A
Last Name:MONZON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1301 PLANTATION ISLAND DR S
Mailing Address - Street 2:SUITE 301A
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3108
Mailing Address - Country:US
Mailing Address - Phone:904-460-9555
Mailing Address - Fax:904-460-0090
Practice Address - Street 1:1301 PLANTATION ISLAND DR S
Practice Address - Street 2:SUITE 301A
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3108
Practice Address - Country:US
Practice Address - Phone:904-460-9555
Practice Address - Fax:904-460-0090
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME51281207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10236DMedicare PIN
FLE42547Medicare UPIN