Provider Demographics
NPI:1265871842
Name:THE MONARCH COLLECTIVE
Entity type:Organization
Organization Name:THE MONARCH COLLECTIVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-309-1618
Mailing Address - Street 1:5810 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-2639
Mailing Address - Country:US
Mailing Address - Phone:786-953-6417
Mailing Address - Fax:305-938-5093
Practice Address - Street 1:5810 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-2639
Practice Address - Country:US
Practice Address - Phone:786-953-6417
Practice Address - Fax:305-938-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty