# WILKENS MONDESIR MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811241003
- **Authorized official:** DR. WILKENS MONDESIR M.D. (OWNER)
- **Authorized official phone:** (561) 389-4881

## Contact information

- **Practice address:** 4849 LAKE WORTH RD STE 201, GREENACRES, FL 33463-3462
- **Practice address phone:** (561) 784-7014
- **Practice address fax:** (561) 784-7922
- **Mailing address:** 4849 LAKE WORTH RD STE 201, GREENACRES, FL 33463-3462
- **Mailing address phone:** (561) 784-7014
- **Mailing address fax:** (561) 784-7922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME113026 | FL | — |
| 207VG0400X | Gynecology Physician | ME113026 | FL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | ME113026 | FL | — |
| 207VX0000X | Obstetrics Physician | ME113026 | FL | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | ME113026 | FL | — |

## Other

- **Enumeration date:** 11/09/2012
- **Last updated:** 08/16/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010956200 | — | FL |