Individual provider Active NPI

Mia Monsalve, PA-C

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1033863089
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9115450 Issued in FL
Practice address
2701 54TH Ave S
St Petersburg, FL 33712-4777
Phone
(727) 867-5788
Fax
(727) 867-3255
NPI assigned
Feb 8, 2022
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9115450 FL Primary

Addresses

Primary practice location

2701 54TH Ave S
St Petersburg, FL 33712-4777

Mailing address

2600 Pass a Grille Way
St Pete Beach, FL 33706-4162
Phone (813) 924-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9115450FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics CurrentSince May 25, 2025 Accepting new patients
Mariano D Cibran, MD Corp Dba St Petersburg Pediatrics PastSince May 25, 2025 Accepting new patients

Locations

2701 54th Ave S
St Petersburg, FL 33712
Phone (727) 867-5788

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1033863089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 PASS A GRILLE WAY",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337064162",
            "telephone_number": "813-924-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 54TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337124777",
            "telephone_number": "727-867-5788",
            "fax_number": "727-867-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONSALVE",
        "first_name": "MIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9115450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.