Provider Demographics
NPI:1295144244
Name:MONTANEZ, MARIA DEL CARMEN (MS)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVE R CORDERO STE 140
Mailing Address - Street 2:PMB 393
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-4303
Mailing Address - Country:US
Mailing Address - Phone:787-220-3227
Mailing Address - Fax:787-745-3660
Practice Address - Street 1:110 CALLE GAUTIER BENITEZ
Practice Address - Street 2:PD PLAZA LOCAL 6
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5553
Practice Address - Country:US
Practice Address - Phone:787-220-3227
Practice Address - Fax:787-745-3660
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist