Provider Demographics
NPI:1841596640
Name:MONDESIR, STEPHANIE
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:MONDESIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 25TH ST E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-2607
Mailing Address - Country:US
Mailing Address - Phone:941-592-2707
Mailing Address - Fax:
Practice Address - Street 1:1205 25TH ST E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-2607
Practice Address - Country:US
Practice Address - Phone:941-592-2707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter