Provider Demographics
NPI:1043398175
Name:BARBOUR, MONIQUE MICHELLE (MD)
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:MICHELLE
Last Name:BARBOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7657 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-432-4141
Mailing Address - Fax:561-432-4166
Practice Address - Street 1:7657 LAKE WORTH
Practice Address - Street 2:
Practice Address - City:LAKE WORTH FL
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-432-4141
Practice Address - Fax:561-432-4166
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68835207W00000X, 207R00000X, 207P00000X, 207Q00000X, 208M00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27420OtherBCBS
FL379780501Medicaid
FL379780501Medicaid
F65593Medicare UPIN