Provider Demographics
NPI:1720719305
Name:OLBRYCHT, MONIKA ANNA
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:ANNA
Last Name:OLBRYCHT
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 1:22518 SW 94TH PATH
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1264
Mailing Address - Country:US
Mailing Address - Phone:954-873-0794
Mailing Address - Fax:
Practice Address - Street 1:22518 SW 94TH PATH
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1264
Practice Address - Country:US
Practice Address - Phone:954-873-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist