Provider Demographics
NPI:1851602593
Name:JANUARY, EBONI CHRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:EBONI
Middle Name:CHRISTINA
Last Name:JANUARY
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 1:910 MORRISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3504
Mailing Address - Country:US
Mailing Address - Phone:573-268-4830
Mailing Address - Fax:
Practice Address - Street 1:1600 S ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2510
Practice Address - Country:US
Practice Address - Phone:954-355-4400
Practice Address - Fax:954-355-4797
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA91849207V00000X
TXT9136207V00000X
CT64605207V00000X
FLME143577207V00000X
NY300032207V00000X
DCMD210001911207V00000X
IL036150150207V00000X
CAC184151207V00000X
NC2023-00015207V00000X
VA0101280447207V00000X
MO2014012421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology