Provider Demographics
NPI:1821756362
Name:MONTOYA, SANDRA MARYORY
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARYORY
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8534 SUN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7951
Mailing Address - Country:US
Mailing Address - Phone:321-368-3551
Mailing Address - Fax:
Practice Address - Street 1:12701 S JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-3420
Practice Address - Country:US
Practice Address - Phone:407-203-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide