Provider Demographics
NPI:1932329869
Name:MONTPEROUS, JUDITH
Entity Type:Individual
Prefix:MISS
First Name:JUDITH
Middle Name:
Last Name:MONTPEROUS
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 1:1001 SW 191ST TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6095
Mailing Address - Country:US
Mailing Address - Phone:954-499-0495
Mailing Address - Fax:
Practice Address - Street 1:1001 SW 191ST TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-6095
Practice Address - Country:US
Practice Address - Phone:954-499-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist