Provider Demographics
NPI:1730458910
Name:UNDERWOOD, MONIQUE SHAREE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:SHAREE
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1923
Mailing Address - Country:US
Mailing Address - Phone:407-872-7207
Mailing Address - Fax:
Practice Address - Street 1:400 E CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1923
Practice Address - Country:US
Practice Address - Phone:407-872-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist