Provider Demographics
NPI:1194565275
Name:MEDLEY, MONIQUE (MBA)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 SE 33RD TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5955
Mailing Address - Country:US
Mailing Address - Phone:305-799-2833
Mailing Address - Fax:
Practice Address - Street 1:13319 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6267
Practice Address - Country:US
Practice Address - Phone:786-357-3938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide