Provider Demographics
NPI:1134495898
Name:MONTOYA, CANDACE (LAP)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9423 MYRTLE CREEK LN APT 508
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5978
Mailing Address - Country:US
Mailing Address - Phone:972-979-6034
Mailing Address - Fax:
Practice Address - Street 1:6917 NARCOOSSEE RD STE 734
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-7002
Practice Address - Country:US
Practice Address - Phone:407-801-5510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3106171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist