Provider Demographics
NPI:1710785431
Name:MONZON, SANDYMIGUEL
Entity type:Individual
Prefix:
First Name:SANDYMIGUEL
Middle Name:
Last Name:MONZON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 W 39TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7242
Mailing Address - Country:US
Mailing Address - Phone:786-474-5436
Mailing Address - Fax:
Practice Address - Street 1:803 W 39TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7242
Practice Address - Country:US
Practice Address - Phone:786-474-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM525-780-00-131-0247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other