Provider Demographics
NPI:1841675899
Name:MONALIS
Entity type:Organization
Organization Name:MONALIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOKESH
Authorized Official - Middle Name:V
Authorized Official - Last Name:VATTIGUNTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-427-3436
Mailing Address - Street 1:119 TALAVERA PL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6221
Mailing Address - Country:US
Mailing Address - Phone:561-427-3436
Mailing Address - Fax:561-616-6408
Practice Address - Street 1:119 TALAVERA PL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-6221
Practice Address - Country:US
Practice Address - Phone:561-427-3436
Practice Address - Fax:561-616-6408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty