Provider Demographics
NPI:1770505125
Name:MONTERO, NURIS (MS,OTR/L)
Entity Type:Individual
Prefix:
First Name:NURIS
Middle Name:
Last Name:MONTERO
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 N LECANTO HWY
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-3548
Mailing Address - Country:US
Mailing Address - Phone:352-527-5433
Mailing Address - Fax:352-527-4199
Practice Address - Street 1:3470 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:FL
Practice Address - Zip Code:34465-3548
Practice Address - Country:US
Practice Address - Phone:352-527-5433
Practice Address - Fax:352-527-4199
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11967225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC12867OtherMEDICARE R.R. GROUP
FLU5486ZMedicare ID - Type Unspecified