Provider Demographics
NPI:1073883112
Name:MONTALVO, TATIANA (PHD)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:TATIANA
Other - Middle Name:
Other - Last Name:MONTALVO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:651 WHITETAIL LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-3121
Mailing Address - Country:US
Mailing Address - Phone:787-310-0250
Mailing Address - Fax:
Practice Address - Street 1:651 WHITETAIL LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-3121
Practice Address - Country:US
Practice Address - Phone:787-310-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist