Healthcare Provider Details

I. General information

NPI: 1407035009
Provider Name (Legal Business Name): MONA I CHIRIBAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 3RD ST STE 102
NEPTUNE BEACH FL
32266-5082
US

IV. Provider business mailing address

PO BOX 746636
ATLANTA GA
30374-6636
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-4243
  • Fax: 904-202-4639
Mailing address:
  • Phone: 904-202-2092
  • Fax: 904-376-4075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME107886
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME107886
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: