Provider Demographics
NPI:1467805317
Name:MARY MONPLAISIR
Entity Type:Organization
Organization Name:MARY MONPLAISIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL FOSTER PARENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MONPLAISIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-201-3712
Mailing Address - Street 1:915 LOUVRE CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3840
Mailing Address - Country:US
Mailing Address - Phone:407-201-3712
Mailing Address - Fax:407-201-3712
Practice Address - Street 1:915 LOUVRE CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3840
Practice Address - Country:US
Practice Address - Phone:407-201-3712
Practice Address - Fax:407-201-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253J00000X253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency