Provider Demographics
NPI:1922870120
Name:MONTALBANO, CHRISTINA (MOT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MONTALBANO
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 SE COURANCES DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-6666
Mailing Address - Country:US
Mailing Address - Phone:561-758-7561
Mailing Address - Fax:
Practice Address - Street 1:4362 NORTHLAKE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6270
Practice Address - Country:US
Practice Address - Phone:561-625-6860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT24705225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics