Provider Demographics
NPI:1205373941
Name:MONTANE, IANE
Entity Type:Individual
Prefix:
First Name:IANE
Middle Name:
Last Name:MONTANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IANE
Other - Middle Name:
Other - Last Name:MONTANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27242 SW 164TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-2802
Mailing Address - Country:US
Mailing Address - Phone:305-879-5089
Mailing Address - Fax:
Practice Address - Street 1:1180 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4413
Practice Address - Country:US
Practice Address - Phone:786-349-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician