Provider Demographics
NPI:1336790294
Name:MONZON, MAYDENIS (MSOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MAYDENIS
Middle Name:
Last Name:MONZON
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 SW 153RD PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33194-2662
Mailing Address - Country:US
Mailing Address - Phone:305-903-0993
Mailing Address - Fax:305-364-0338
Practice Address - Street 1:456 W 51ST PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3620
Practice Address - Country:US
Practice Address - Phone:305-364-0337
Practice Address - Fax:305-364-0338
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18877225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist