Provider Demographics
NPI:1639386592
Name:MONTOYO-SERRANO, MARIA A (BA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:MONTOYO-SERRANO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 S RIDGEWOOD AVE
Mailing Address - Street 2:OUR CHILDREN FIRST
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4929
Mailing Address - Country:US
Mailing Address - Phone:386-248-2771
Mailing Address - Fax:386-248-2874
Practice Address - Street 1:517 S RIDGEWOOD AVE
Practice Address - Street 2:OUR CHILDREN FIRST
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4929
Practice Address - Country:US
Practice Address - Phone:386-248-2771
Practice Address - Fax:386-248-2874
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator