Provider Demographics
NPI:1881490571
Name:MONTGOMERY, LOVE SHAREESE (HHA)
Entity type:Individual
Prefix:
First Name:LOVE SHAREESE
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 SANDY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7917
Mailing Address - Country:US
Mailing Address - Phone:717-650-9258
Mailing Address - Fax:
Practice Address - Street 1:606 SANDY CREEK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7917
Practice Address - Country:US
Practice Address - Phone:717-650-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care