Provider Demographics
NPI:1619467362
Name:MONTES DE OCA CORP
Entity Type:Organization
Organization Name:MONTES DE OCA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MONTES DE OCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-769-1716
Mailing Address - Street 1:130 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-2404
Mailing Address - Country:US
Mailing Address - Phone:561-762-1615
Mailing Address - Fax:561-855-2398
Practice Address - Street 1:130 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-2404
Practice Address - Country:US
Practice Address - Phone:561-762-1615
Practice Address - Fax:561-855-2398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVH4559343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)