Provider Demographics
NPI:1104579135
Name:MONARCH THERAPY SERVICES
Entity type:Organization
Organization Name:MONARCH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GULLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-935-9376
Mailing Address - Street 1:33607 HAMILTON HILL LN
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-5373
Mailing Address - Country:US
Mailing Address - Phone:703-935-9376
Mailing Address - Fax:
Practice Address - Street 1:33607 HAMILTON HILL LN
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-5373
Practice Address - Country:US
Practice Address - Phone:703-935-9376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018697200Medicaid