Provider Demographics
NPI:1891296083
Name:JUKAS, MONICA (HAS)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:JUKAS
Suffix:
Gender:F
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4551 MAINLANDS BLVD W STE A
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-5637
Mailing Address - Country:US
Mailing Address - Phone:727-576-6160
Mailing Address - Fax:727-576-6165
Practice Address - Street 1:4561 MAINLANDS BLVD W
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5657
Practice Address - Country:US
Practice Address - Phone:727-576-6160
Practice Address - Fax:727-576-6165
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4630237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist