Provider Demographics
NPI:1720854011
Name:MONZON PEREZ, SANDER
Entity Type:Individual
Prefix:
First Name:SANDER
Middle Name:
Last Name:MONZON PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 VAN BUREN PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-3701
Mailing Address - Country:US
Mailing Address - Phone:786-862-9815
Mailing Address - Fax:
Practice Address - Street 1:229 DEL PRADO BLVD N STE 10
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2266
Practice Address - Country:US
Practice Address - Phone:239-347-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty