Provider Demographics
NPI:1437808920
Name:MONTERO, JOSEL DALANGIN
Entity Type:Individual
Prefix:
First Name:JOSEL
Middle Name:DALANGIN
Last Name:MONTERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4387 KELSON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-3073
Mailing Address - Country:US
Mailing Address - Phone:850-718-6248
Mailing Address - Fax:
Practice Address - Street 1:4387 KELSON AVE APT A
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-3073
Practice Address - Country:US
Practice Address - Phone:850-718-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily