Provider Demographics
NPI:1811360779
Name:ROLO, MONICA (APRN)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:ROLO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:ROLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:2600 LAUREL ROAD EAST
Mailing Address - Street 2:
Mailing Address - City:NORTH VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34275
Mailing Address - Country:US
Mailing Address - Phone:941-361-1100
Mailing Address - Fax:941-361-1103
Practice Address - Street 1:2600 LAUREL ROAD EAST
Practice Address - Street 2:
Practice Address - City:NORTH VENICE
Practice Address - State:FL
Practice Address - Zip Code:34275
Practice Address - Country:US
Practice Address - Phone:941-361-1100
Practice Address - Fax:941-361-1103
Is Sole Proprietor?:No
Enumeration Date:2015-11-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9305880363LF0000X
FLARNP9305880363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111031400Medicaid