Provider Demographics
NPI:1598062630
Name:BASTIEN-MONTPEIROUS, NATHALIE (MD)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:BASTIEN-MONTPEIROUS
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 1:8140 OKEECHOBEE BLVD STE A&B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2003
Mailing Address - Country:US
Mailing Address - Phone:561-293-4301
Mailing Address - Fax:561-293-4301
Practice Address - Street 1:6056 BOYNTON BEACH BLVD STE 115
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3500
Practice Address - Country:US
Practice Address - Phone:561-708-1760
Practice Address - Fax:561-469-9375
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME11865207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine