Provider Demographics
NPI:1245948546
Name:MONROE, BRIAN T
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:T
Last Name:MONROE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15539 SARANAC RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2458
Mailing Address - Country:US
Mailing Address - Phone:216-785-9339
Mailing Address - Fax:
Practice Address - Street 1:8215 BEACON PL
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-4272
Practice Address - Country:US
Practice Address - Phone:216-785-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker