Provider Demographics
NPI:1609131291
Name:MONTERO, PERLA
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:MONTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 49TH ST STE 332
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3489
Mailing Address - Country:US
Mailing Address - Phone:305-556-0121
Mailing Address - Fax:305-556-1372
Practice Address - Street 1:900 W 49TH ST STE 332
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3489
Practice Address - Country:US
Practice Address - Phone:305-556-0121
Practice Address - Fax:305-556-1372
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS0I1262355S0801X
FLSZ7480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant