Tirtarahardja, Monica
Tirtarahardja, Monica is an sole proprietor health care provider with primary practice located at 5503 S Congress Ave Ste 204 , Lake Worth FL 33462-6626. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Tirtarahardja, Monica can be contacted via phone (561) 410-5110.Contact Information
Primary practice address
5503 S Congress Ave Ste 204
Lake Worth FL 33462-6626
Phone: (561) 410-5110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9112886 | Florida |
Profile Details
| NPI number | 1770117830 |
|---|---|
| LBN Legal business name | Tirtarahardja, Monica |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2020 |
| Last updated | Jul 12th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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