Provider Demographics
NPI:1013055334
Name:MONTERO, SANDRA M (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:MONTERO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 W 20TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1895
Mailing Address - Country:US
Mailing Address - Phone:305-822-8815
Mailing Address - Fax:305-822-8873
Practice Address - Street 1:2140 W 68TH ST
Practice Address - Street 2:STE 101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-822-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT8785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7783AOtherMEDICARE LEGACY
FLE7783AOtherMEDICARE LEGACY