Provider Demographics
NPI:1821499443
Name:HABIB, MONICA (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HABIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:HABIB-HEGHINIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4560 LANTANA RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6998
Mailing Address - Country:US
Mailing Address - Phone:561-795-8655
Mailing Address - Fax:561-795-8449
Practice Address - Street 1:4560 LANTANA RD STE 110
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6998
Practice Address - Country:US
Practice Address - Phone:561-795-8655
Practice Address - Fax:561-795-8449
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 121496208100000X, 2081P2900X
FLME121496208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHY579ZMedicare PIN
FLHY579YMedicare PIN