Provider Demographics
NPI:1518711548
Name:MONTES, MICHAEL ANDRES (APRN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDRES
Last Name:MONTES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 SW 123RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1175
Mailing Address - Country:US
Mailing Address - Phone:305-282-3246
Mailing Address - Fax:
Practice Address - Street 1:2410 SW 123RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1175
Practice Address - Country:US
Practice Address - Phone:305-282-3246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner