Provider Demographics
NPI:1366952921
Name:GEORGE W MONLUX JR MD INC
Entity type:Organization
Organization Name:GEORGE W MONLUX JR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MONLUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:727-564-8656
Mailing Address - Street 1:4602 27TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33711-3704
Mailing Address - Country:US
Mailing Address - Phone:727-564-8656
Mailing Address - Fax:
Practice Address - Street 1:4602 27TH AVE S
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33711-3704
Practice Address - Country:US
Practice Address - Phone:727-564-8656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty