Active NPI
Jacquelyn Monzon, PAC
- Physician Assistant
- Hialeah, FL
National Provider Identifier
1891069431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-9106309
- Practice address
- 16161 NW 57TH Ave
Hialeah, FL 33014-6707 - Phone
- (305) 625-3409
- Fax
- (305) 625-2734
- NPI assigned
- Feb 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-9106309 | FL | Primary |
Addresses
Primary practice location
16161 NW 57TH Ave
Hialeah, FL 33014-6707
Mailing address
16161 NW 57TH Ave
Hialeah, FL 33014-6707
Phone (305) 625-3409
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA-9106309 | Other | FL | STATE LICSENCE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-9106309 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1891069431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16161 NW 57TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330146707",
"telephone_number": "305-625-3409",
"fax_number": "305-625-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16161 NW 57TH AVE",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330146707",
"telephone_number": "305-625-3409",
"fax_number": "305-625-2734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONZON",
"first_name": "JACQUELYN",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA-9106309",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICSENCE",
"identifier": "PA-9106309",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.