Provider Demographics
NPI:1255075651
Name:MONTANEZ, JULIAN (RBT)
Entity type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:
Last Name:MONTANEZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 MARTIGUES DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3411
Mailing Address - Country:US
Mailing Address - Phone:407-738-6587
Mailing Address - Fax:
Practice Address - Street 1:414 MARTIGUES DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3411
Practice Address - Country:US
Practice Address - Phone:407-738-6587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM535420902680106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician