Individual
MONIQUE MICHELLE MONDESIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
150 SW CHAMBER CT STE 101, PORT ST LUCIE, FL 34986-3413
(772) 301-0123
(772) 301-0124
Mailing address
150 SW CHAMBER CT STE 101, PORT ST LUCIE, FL 34986-3413
(772) 301-0123
(772) 301-0124
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME115811
FL
390200000X
Student in an Organized Health Care Education/Training Program
MT196440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009212800
—
FL
Enumeration date
06/28/2010
Last updated
09/10/2018
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