Provider Demographics
NPI:1205420338
Name:MONTEAGUDO, FELIX CALIXTO (CCSH, RPSGT, CRT)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:CALIXTO
Last Name:MONTEAGUDO
Suffix:
Gender:M
Credentials:CCSH, RPSGT, CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PIONEERS MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641-3181
Mailing Address - Country:US
Mailing Address - Phone:970-693-6025
Mailing Address - Fax:970-693-6028
Practice Address - Street 1:100 PIONEERS MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MEEKER
Practice Address - State:CO
Practice Address - Zip Code:81641-3181
Practice Address - Country:US
Practice Address - Phone:970-693-6025
Practice Address - Fax:970-693-6028
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1118246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other