Provider Demographics
NPI:1679581748
Name:MONTILLA, FERNANDO J (M D)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:J
Last Name:MONTILLA
Suffix:
Gender:M
Credentials:M D
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Other - Credentials:
Mailing Address - Street 1:Y3 CALLE HASTINGS
Mailing Address - Street 2:GARDEN HILLS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2832
Mailing Address - Country:US
Mailing Address - Phone:787-727-4333
Mailing Address - Fax:787-268-7077
Practice Address - Street 1:611 M PAVIA FERNANDEZ ST
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-727-4333
Practice Address - Fax:787-268-7077
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR002613207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology