Provider Demographics
NPI:1659456259
Name:MONSON, ANTONIO P (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:P
Last Name:MONSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3081 ROOSEVELT BLVD SUITE 300
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4021
Mailing Address - Country:US
Mailing Address - Phone:727-259-3889
Mailing Address - Fax:
Practice Address - Street 1:3081 ROOSEVELT BLVD STE 300
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3422
Practice Address - Country:US
Practice Address - Phone:727-259-3889
Practice Address - Fax:727-213-6744
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82686207Y00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMEDICAL LICENSEOtherME82686