Provider Demographics
NPI:1518617455
Name:HILL, MONIQUE A
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:A
Last Name:HILL
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 1:481 MERCURY AVE SE APT 107
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-4218
Mailing Address - Country:US
Mailing Address - Phone:321-205-4132
Mailing Address - Fax:
Practice Address - Street 1:481 MERCURY AVE SE APT 107
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-4218
Practice Address - Country:US
Practice Address - Phone:321-205-4132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18292224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant