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Monexor Medical Billing
NPI # 17401170174
Address: 2007 23rd Ave, Tampa Florida, 33605
Phone: 1+ 972 330 6955
Email: monexor@hotmail.com
PATIENT INFORMATION
Full Name:
DOB:
SSN:
Gender:
INVOICE INFORMATION
Invoice Number:Service Performed on:
Reason For Visit:
| # | CPT Code | Service Description | Qty | Minutes | Unit Price | SubTotal | |
|---|---|---|---|---|---|---|---|
| 1 | 0.00 |
TOTAL: $0.00