Individual
MONAE GREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11613 STORYWOOD DR, RIVERVIEW, FL 33578-3125
(813) 567-6891
Mailing address
11613 STORYWOOD DR, RIVERVIEW, FL 33578-3125
(813) 567-6891
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
82315866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
CRANIAL PROSTHESIS
FL
Enumeration date
09/07/2018
Last updated
09/07/2018
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