Provider Demographics
NPI:1407957400
Name:MONTFORD, BARBARA ANN (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:MONTFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N.W. 95 ST
Mailing Address - Street 2:#106
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33150
Mailing Address - Country:US
Mailing Address - Phone:305-696-0806
Mailing Address - Fax:305-696-8519
Practice Address - Street 1:1190 N.W. 95 ST
Practice Address - Street 2:#106
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33150
Practice Address - Country:US
Practice Address - Phone:305-696-0806
Practice Address - Fax:305-696-8519
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00626605208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371036000Medicaid
FL371036000Medicaid
C85617Medicare UPIN