Provider Demographics
NPI:1346791340
Name:CDT DOCTORES MONTALVO LLC
Entity Type:Organization
Organization Name:CDT DOCTORES MONTALVO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:N
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-880-1020
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0846
Mailing Address - Country:US
Mailing Address - Phone:787-880-1020
Mailing Address - Fax:787-879-4441
Practice Address - Street 1:51 CALLE GAUTIER BENITEZ
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4418
Practice Address - Country:US
Practice Address - Phone:787-880-1020
Practice Address - Fax:787-879-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty