Provider Demographics
NPI:1457668055
Name:LUIS F MONTANO MD PA
Entity Type:Organization
Organization Name:LUIS F MONTANO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-267-0333
Mailing Address - Street 1:PO BOX 144943
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-4943
Mailing Address - Country:US
Mailing Address - Phone:305-267-0333
Mailing Address - Fax:305-264-5494
Practice Address - Street 1:5871 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5703
Practice Address - Country:US
Practice Address - Phone:305-267-0333
Practice Address - Fax:305-264-5494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60057207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370585400Medicaid
FL370585400Medicaid