MEDICARE: MONIQUE MICHELLE MONDESIR 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	ME115811	FL
2	390200000X	Student in an Organized Health Care Education/Training Program	MT196440	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770894438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE MICHELLE MONDESIR M.D.

Provider Business Mailing Address
First Line	:	150 SW CHAMBER CT STE 101
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-3413
Country	:	US
Telephone Number	:	772-301-0123
Fax Number	:	772-301-0124

Provider Business Practice Location Address
First Line	:	150 SW CHAMBER CT STE 101
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34986-3413
Country	:	US
Telephone Number	:	772-301-0123
Fax Number	:	772-301-0124

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

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	09/10/2018

Similar Medicare Providers

1346662186 — NATIONAL SURGICAL CENTERS OF AMERICA LLC
Practice Location Address:

150 SW CHAMBER CT. , SUITE 105
PORT ST. LUCIE, FL
34986-3413

Practice Phone: 772-807-9000
Practice Fax: 772-807-9087

1801864160 — DR. ANTHONY F. AFONG M.D.
Practice Location Address:

150 SW CHAMBER COURT , SUITE 105
PORT ST LUCIE, FL
34986-3413

Practice Phone: 772-807-9000
Practice Fax: 772-807-9087

1629003553 — DR. KIMBERLY B. ORAM PSY.D.
Practice Location Address:

150 SW CHAMBER CT , SUITE 105
PORT ST LUCIE, FL
34986-3413

Practice Phone: 772-809-9000
Practice Fax: 772-809-9087

1215046446 — JAROSLAW CEGIELSKI D.M.D.
Practice Location Address:

150 SW CHAMBER CT , SUITE 201
PORT SAINT LUCIE, FL
34986-3413

Practice Phone: 772-336-8253
Practice Fax:

1629190731 — JENNIFER RAE WITT CPNP
Practice Location Address:

150 SW CHAMBER CT STE 101
PORT ST LUCIE, FL
34986-3413

Practice Phone: 772-301-0123
Practice Fax: 772-301-0124

1861612483 — FLORIDA PAIN & REHABILITATION INSTITUTE INC
Practice Location Address:

150 SW CHAMBER CT , STE 105
PORT ST LUCIE, FL
34986-3413

Practice Phone: 772-807-9000
Practice Fax: 772-807-9087

Directions to “ MONIQUE MICHELLE MONDESIR M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.