Individual
DR. MONIQUE LASHAWNE UPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1340 RIDGEWOOD AVE, HOLLY HILL, FL 32117-2320
(386) 676-7175
(386) 676-7134
Mailing address
PO BOX 9671, DAYTONA BEACH, FL 32120-9671
(386) 676-7130
(386) 676-7125
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME116163
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006241300
—
FL
01
—
14M8T
BCBS
FL
01
—
1669679353
TRICARE
FL
05
—
7100148830
—
KY
01
—
K226510
MEDICARE
KY
Enumeration date
06/27/2007
Last updated
03/19/2025
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