Provider Demographics
NPI:1477262269
Name:MONET OLMEDA, IRIS LAURA
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:LAURA
Last Name:MONET OLMEDA
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 1:13692 YOUNGSTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4915
Mailing Address - Country:US
Mailing Address - Phone:407-883-4973
Mailing Address - Fax:
Practice Address - Street 1:365 CITRUS TOWER BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6532
Practice Address - Country:US
Practice Address - Phone:407-883-4973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker