Provider Demographics
NPI:1720161268
Name:MONTALVO, KARINELL M (MD)
Entity Type:Individual
Prefix:MRS
First Name:KARINELL
Middle Name:M
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1021
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-659-7081
Mailing Address - Fax:787-659-7081
Practice Address - Street 1:CALLE FERROCARIL #1
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN GERMAIN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-659-7081
Practice Address - Fax:787-659-7081
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15606208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice