MEDICARE: DR. MARIBEL MONSALVE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME82810	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01943	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	9913059	OTHER	FL	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487723979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIBEL MONSALVE M.D.

Provider Business Mailing Address
First Line	:	2344 3RD ST S
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32250-4023
Country	:	US
Telephone Number	:	904-253-2555
Fax Number	:	904-253-2418

Provider Business Practice Location Address
First Line	:	900 UNIVERSITY BLVD N
Second Line	:	MC-75
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-5530
Country	:	US
Telephone Number	:	904-253-1002
Fax Number	:	904-253-1942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	01/25/2016

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