Provider Demographics
NPI:1760664429
Name:MONTANER MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:MONTANER MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:305-326-7777
Mailing Address - Street 1:1901 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1513
Mailing Address - Country:US
Mailing Address - Phone:305-326-7777
Mailing Address - Fax:305-326-7797
Practice Address - Street 1:1901 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1513
Practice Address - Country:US
Practice Address - Phone:305-326-7777
Practice Address - Fax:305-326-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty