Provider Demographics
NPI:1952944746
Name:CARTER, MONIQUE SHARRIE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:SHARRIE
Last Name:CARTER
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:PO BOX 343507
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-0507
Mailing Address - Country:US
Mailing Address - Phone:786-554-2284
Mailing Address - Fax:
Practice Address - Street 1:2372 SE 12TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-2150
Practice Address - Country:US
Practice Address - Phone:786-554-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QD1600X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities