Provider Demographics
NPI:1518501279
Name:RAMOS MONTALVO, PAOLA MARIE (DC)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:MARIE
Last Name:RAMOS MONTALVO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 BRIAR CLIFF DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4410
Mailing Address - Country:US
Mailing Address - Phone:787-407-3690
Mailing Address - Fax:
Practice Address - Street 1:421 MONTGOMERY RD STE 165
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-6824
Practice Address - Country:US
Practice Address - Phone:407-960-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor