Provider Demographics
NPI:1376098251
Name:MONTENEGRO, CLAUDIA (DO)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:MONTENEGRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4616
Mailing Address - Country:US
Mailing Address - Phone:561-279-2665
Mailing Address - Fax:561-278-6732
Practice Address - Street 1:225 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4616
Practice Address - Country:US
Practice Address - Phone:561-279-2665
Practice Address - Fax:561-278-6732
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 14139207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine