Provider Demographics
NPI:1912181447
Name:MONICA P ILIEVSKI ARNP PA
Entity Type:Organization
Organization Name:MONICA P ILIEVSKI ARNP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ILIEVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-573-3397
Mailing Address - Street 1:8621 SW 87TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4553
Mailing Address - Country:US
Mailing Address - Phone:786-573-3397
Mailing Address - Fax:786-573-3397
Practice Address - Street 1:8621 SW 87TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4553
Practice Address - Country:US
Practice Address - Phone:786-573-3397
Practice Address - Fax:786-573-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3015172364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8150Medicare PIN