Provider Demographics
NPI:1215233457
Name:JONES, MONICA RESTREPO (LMT, MMP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:RESTREPO
Last Name:JONES
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:RESTREPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT, MMP
Mailing Address - Street 1:101 LAKE HAYES RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9097
Mailing Address - Country:US
Mailing Address - Phone:407-314-0396
Mailing Address - Fax:
Practice Address - Street 1:101 LAKE HAYES RD
Practice Address - Street 2:SUITE 105
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9097
Practice Address - Country:US
Practice Address - Phone:407-314-0396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-06
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48008225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist