Provider Demographics
NPI:1356123681
Name:MONCION, JUDITH
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:MONCION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3469 WEST BOYNTON BEACH
Mailing Address - Street 2:SUITE 2 PMB 1023
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4639
Mailing Address - Country:US
Mailing Address - Phone:954-415-1879
Mailing Address - Fax:
Practice Address - Street 1:3621 TURTLE RUN BLVD
Practice Address - Street 2:UNIT 1034
Practice Address - City:CORAL SPRING
Practice Address - State:FL
Practice Address - Zip Code:33067
Practice Address - Country:US
Practice Address - Phone:954-415-1879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246RP1900X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy