Provider Demographics
NPI:1205805991
Name:DIBBS VALLEE, MONIQUE P (MD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:P
Last Name:DIBBS VALLEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MONIQUE
Other - Middle Name:P DIBBS
Other - Last Name:VALLEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-6260
Mailing Address - Fax:239-343-6259
Practice Address - Street 1:9981 S HEALTHPARK DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-343-6260
Practice Address - Fax:239-343-6259
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14736R208000000X
FLME82202208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103608500Medicaid
LA1155292Medicaid