Provider Demographics
NPI:1700015245
Name:MONCADA, STEVEN (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MONCADA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 SW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0325
Mailing Address - Country:US
Mailing Address - Phone:352-629-3455
Mailing Address - Fax:352-629-5486
Practice Address - Street 1:1109 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0325
Practice Address - Country:US
Practice Address - Phone:352-629-3455
Practice Address - Fax:352-629-5486
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT262022251X0800X
TX11891632251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic