Provider Demographics
NPI:1508113655
Name:MONTOYA, KATALINA (OTR)
Entity Type:Individual
Prefix:
First Name:KATALINA
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 BRICKELL KEY DR
Mailing Address - Street 2:APT 909
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2600
Mailing Address - Country:US
Mailing Address - Phone:786-543-1503
Mailing Address - Fax:
Practice Address - Street 1:888 BRICKELL KEY DR
Practice Address - Street 2:APT 909
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2600
Practice Address - Country:US
Practice Address - Phone:786-543-1503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14546174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist