Provider Demographics
NPI:1881176642
Name:MONDESIR, STANLEY (RRT)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:MONDESIR
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 OAKS DR APT 304
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3756
Mailing Address - Country:US
Mailing Address - Phone:954-736-9627
Mailing Address - Fax:
Practice Address - Street 1:625 OAKS DR APT 304
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3756
Practice Address - Country:US
Practice Address - Phone:954-736-9627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty