Provider Demographics
NPI:1518649714
Name:MONTANO, RAFAEL E (RMHCI)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:E
Last Name:MONTANO
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 REVELWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9306
Mailing Address - Country:US
Mailing Address - Phone:678-428-9308
Mailing Address - Fax:
Practice Address - Street 1:668 N ORLANDO AVE STE 210
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4459
Practice Address - Country:US
Practice Address - Phone:407-951-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24299101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor