Provider Demographics
NPI:1225586977
Name:MONTESINO, PAUL (VMD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:MONTESINO
Suffix:
Gender:F
Credentials:VMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19630 CYPRESS CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8136
Mailing Address - Country:US
Mailing Address - Phone:786-314-2971
Mailing Address - Fax:
Practice Address - Street 1:19630 CYPRESS CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-8136
Practice Address - Country:US
Practice Address - Phone:786-314-2971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator