Provider Demographics
NPI:1669693107
Name:MARKS, MONIKA KATHERINE (OTR)
Entity type:Individual
Prefix:MISS
First Name:MONIKA
Middle Name:KATHERINE
Last Name:MARKS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 NE 31 AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305
Mailing Address - Country:US
Mailing Address - Phone:786-547-6677
Mailing Address - Fax:
Practice Address - Street 1:1918 NE 31ST AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1815
Practice Address - Country:US
Practice Address - Phone:786-547-6677
Practice Address - Fax:786-547-6677
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 7456225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist