Provider Demographics
NPI:1376591842
Name:MONTERO, DANIEL E (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:MONTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE PLACID
Mailing Address - State:FL
Mailing Address - Zip Code:33852-8123
Mailing Address - Country:US
Mailing Address - Phone:863-465-7010
Mailing Address - Fax:
Practice Address - Street 1:3420 US 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1637
Practice Address - Country:US
Practice Address - Phone:863-385-7077
Practice Address - Fax:863-385-6863
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35950OtherBLUE CROSS
FL260932100Medicaid
FLE4074XMedicare PIN
FLE4074Medicare PIN
FLG98714Medicare UPIN
FL260932100Medicaid
FLE4074YMedicare PIN
FL080166341Medicare PIN