Provider Demographics
NPI:1326007931
Name:MONTES, LUIS ANTONIO JR (DPT)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ANTONIO
Last Name:MONTES
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 WAYCROSS ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240
Mailing Address - Country:US
Mailing Address - Phone:513-792-2333
Mailing Address - Fax:513-742-0943
Practice Address - Street 1:950 GLADES ROAD
Practice Address - Street 2:SUITE 2A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-826-0334
Practice Address - Fax:561-826-0376
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0981AMedicare PIN