MEDICARE: MANUEL D. MONTES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	P00001887	FL

General Provider Information

NPI Number	:	1114255536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANUEL D. MONTES

Provider Business Mailing Address
First Line	:	1000 BELCHER RD S
Second Line	:	STE 4
City	:	LARGO
State	:	FL
Zip	:	33771-3321
Country	:	US
Telephone Number	:	727-530-7578
Fax Number	:	727-573-2048

Provider Business Practice Location Address
First Line	:	1000 BELCHER RD S
Second Line	:	STE 4
City	:	LARGO
State	:	FL
Zip	:	33771-3321
Country	:	US
Telephone Number	:	727-530-7578
Fax Number	:	727-573-2048

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MANUEL D MONTES
Credential	:	DPM
Telephone Number	:	727-530-7578

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	02/24/2010

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