Provider Demographics
NPI:1952969222
Name:MONTANEZ, VALERIE
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MONTANEZ
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 1:2212 RIVER PARK CIR APT 217
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4842
Mailing Address - Country:US
Mailing Address - Phone:305-763-6874
Mailing Address - Fax:
Practice Address - Street 1:211 S BUMBY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-6226
Practice Address - Country:US
Practice Address - Phone:407-801-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2021-04-07
Deactivation Date:2020-06-25
Deactivation Code:
Reactivation Date:2021-04-07
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician