Provider Demographics
NPI:1346446788
Name:MONTILLA, JORGE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:J
Last Name:MONTILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:88 CALLE MAMEY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5115
Mailing Address - Country:US
Mailing Address - Phone:787-789-6534
Mailing Address - Fax:787-789-6534
Practice Address - Street 1:500 AVE DOMENECH
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3736
Practice Address - Country:US
Practice Address - Phone:787-751-1089
Practice Address - Fax:787-751-1089
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR36482084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry