Provider Demographics
NPI:1336032382
Name:MOMPREMIER, ICIKA JOSEPH (RESPIRATORY THERAP)
Entity type:Individual
Prefix:
First Name:ICIKA
Middle Name:JOSEPH
Last Name:MOMPREMIER
Suffix:
Gender:F
Credentials:RESPIRATORY THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:3205 SW 173RD TER FL 33029
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5583
Mailing Address - Country:US
Mailing Address - Phone:786-444-6258
Mailing Address - Fax:
Practice Address - Street 1:3205 SW 173RD TER FL 33029
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5583
Practice Address - Country:US
Practice Address - Phone:786-444-6258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health