Basic Information
| Provider Information | |||||||||
| NPI: | 1366823122 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FELIX | ||||||||
| FirstName: | MONICKA | ||||||||
| MiddleName: | STELLA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11375 CORTEZ BLVD | ||||||||
| Address2: | |||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346135409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525922753 | ||||||||
| FaxNumber: | 3525976173 | ||||||||
| Practice Location | |||||||||
| Address1: | 11375 CORTEZ BOULEVARD, SR 50, OAK HILL HOSPITAL | ||||||||
| Address2: | GME ATTN: MELISSA TAMMARO | ||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525922753 | ||||||||
| FaxNumber: | 3525976173 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 07/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | TRN21851 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | ME135553 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.