MEDICARE: ANDREA MARIE MONTAGUE MD

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	207R00000X	Internal Medicine Physician	ME163406	FL
2	208M00000X	Hospitalist Physician	ME163406	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245853332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE MONTAGUE MD

Provider Business Mailing Address
First Line	:	1607 SAINT JAMES CT STE 1
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5352
Country	:	US
Telephone Number	:	850-431-7289
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 MICCOSUKEE RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5054
Country	:	US
Telephone Number	:	850-431-4556
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2020
Last Update Date	:	01/08/2026

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Directions to “ ANDREA MARIE MONTAGUE MD” Practice Location

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