Provider Demographics
NPI:1558746693
Name:MATO, MONICA MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:MATO
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 1:4218 BRAGANZA AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-6635
Mailing Address - Country:US
Mailing Address - Phone:786-553-1023
Mailing Address - Fax:
Practice Address - Street 1:4425 PONCE DE LEON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1842
Practice Address - Country:US
Practice Address - Phone:305-667-3152
Practice Address - Fax:305-667-6702
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9356359163W00000X
FL9356359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse