Provider Demographics
NPI:1659087658
Name:MONZON GONZALEZ, OLGA MARTHA (NP)
Entity Type:Individual
Prefix:MS
First Name:OLGA
Middle Name:MARTHA
Last Name:MONZON GONZALEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 W 46TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7174
Mailing Address - Country:US
Mailing Address - Phone:786-619-4594
Mailing Address - Fax:
Practice Address - Street 1:1485 W 46TH ST APT 202
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7174
Practice Address - Country:US
Practice Address - Phone:786-619-4594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF11220032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner