Provider Demographics
NPI:1255149571
Name:MONTERO, LIZ KATHERIN
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:KATHERIN
Last Name:MONTERO
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 1:8402 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1704
Mailing Address - Country:US
Mailing Address - Phone:813-573-4060
Mailing Address - Fax:
Practice Address - Street 1:8402 CATALINA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1704
Practice Address - Country:US
Practice Address - Phone:813-573-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician