1558445841 NPI number — JEAN Y. MONICE, M.D., P.A.

Table of content: (NPI 1558445841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558445841 NPI number — JEAN Y. MONICE, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEAN Y. MONICE, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558445841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1825 FOREST HILL BLVD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
WEST PALM BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33406-8902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-433-0206
Provider Business Mailing Address Fax Number:
561-433-1640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1825 FOREST HILL BLVD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
WEST PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33406-8902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-433-0206
Provider Business Practice Location Address Fax Number:
561-433-1640
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MONICE
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
YVENET
Authorized Official Title or Position:
M.D.
Authorized Official Telephone Number:
561-433-0206

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME0069088 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14623 . This is a "STAYWELL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 225094 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 31494 . This is a "BLUE CROSS/BLUE SHIELD FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14623 . This is a "HEALTHEASE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14623 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 90652 . This is a "AMERIGROUP OF FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2509496 . This is a "GHI OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 32535 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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