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Provider Information for 1487014478

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MISS MONICA RAE TRAYLOR PA-C

Gender: FEMALE

Individual NPI: 1487014478

Calendar   Last Updated:  2021-05-03
  Certification Date:  2021-05-03

Details

Name Value
NPI 1487014478
Enumeration Date 2016-03-03
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6041 SW 54TH ST STE 200
OCALA, FL 34474-5521
United States

Phone: 352-857-8417 | Fax: 352-877-2083
View Map External Link
Primary Practice Address 2910 BROWNWOOD BLVD
THE VILLAGES, FL 32163-2032
United States

Phone: 352-674-1790 | Fax: 352-674-8990
View Map External Link
Secondary Practice Address 6041 SW 54TH ST STE 200
OCALA, FL 34474-5521
United States

Phone: 352-857-8417 | Fax: 352-877-2083
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 106912100
Other CIGNA FL 5297418
Other FLORIDA BLUE FL 0D4ZE
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363A00000X - Physician Assistant FL PA9109388