Provider Demographics
NPI:1891982666
Name:MONCAYO, JOSEPH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MONCAYO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 NW 102ND TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2377
Mailing Address - Country:US
Mailing Address - Phone:954-604-6250
Mailing Address - Fax:
Practice Address - Street 1:4351 NW 102ND TER
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2377
Practice Address - Country:US
Practice Address - Phone:954-604-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40386183500000X
VA0202216425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist