Provider Demographics
NPI:1164170437
Name:EXUME, MONIQUE (FNP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:EXUME
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 GALICIA ST SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-1323
Mailing Address - Country:US
Mailing Address - Phone:321-557-7225
Mailing Address - Fax:
Practice Address - Street 1:229 GALICIA ST SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-1323
Practice Address - Country:US
Practice Address - Phone:321-557-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11017813363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily