Provider Demographics
NPI:1821227133
Name:KUMAR, MONIQUE GUPTA (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:GUPTA
Last Name:KUMAR
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 1:615 E PRINCETON ST STE 416
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1469
Mailing Address - Country:US
Mailing Address - Phone:407-303-1687
Mailing Address - Fax:407-303-1729
Practice Address - Street 1:615 E PRINCETON ST STE 416
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1469
Practice Address - Country:US
Practice Address - Phone:407-303-1687
Practice Address - Fax:407-303-1729
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2016-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013012520207N00000X
FLME127776207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology