Provider Demographics
NPI:1215441449
Name:MONZON, EVELIN
Entity type:Individual
Prefix:MISS
First Name:EVELIN
Middle Name:
Last Name:MONZON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 SW 140TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6447
Mailing Address - Country:US
Mailing Address - Phone:786-424-9169
Mailing Address - Fax:305-907-5322
Practice Address - Street 1:7789 NW 146TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1567
Practice Address - Country:US
Practice Address - Phone:305-824-0230
Practice Address - Fax:305-907-5322
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty