Basic Information
Provider Information
NPI: 1548702574
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONROSE
FirstName: ANEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14750 NW 77TH CT
Address2: SUITE 200
City: MIAMI LAKES
State: FL
PostalCode: 330161507
CountryCode: US
TelephoneNumber: 3056855688
FaxNumber: 7866185307
Practice Location
Address1: 1200 NE 125TH ST
Address2:  
City: NORTH MIAMI
State: FL
PostalCode: 331615936
CountryCode: US
TelephoneNumber: 3056855688
FaxNumber: 3058915515
Other Information
ProviderEnumerationDate: 11/08/2016
LastUpdateDate: 11/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP9407345FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LA2200XARNP9407345FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
363LG0600XARNP9407345FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363LP2300XARNP9407345FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

No ID Information.


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