Provider Demographics
NPI:1619077963
Name:MONTAGNER, JENNY ARELY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:ARELY
Last Name:MONTAGNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SUNSET DR STE 411
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3013
Mailing Address - Country:US
Mailing Address - Phone:305-491-1032
Mailing Address - Fax:888-491-0809
Practice Address - Street 1:10300 SUNSET DR STE 411
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3013
Practice Address - Country:US
Practice Address - Phone:305-491-1032
Practice Address - Fax:888-491-0809
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7164235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889846400Medicaid