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NPI Code Detail

MEDICARE: ROSALYN NICOLE MONTGOMERY PMHNP-BC

MEDICARE: ROSALYN NICOLE MONTGOMERY PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN11025271FL

General Provider Information

NPI Number : 1730435793
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSALYN NICOLE MONTGOMERY PMHNP-BC
Provider Business Mailing Address
First Line : 3157 N ALAFAYA TRL
Second Line :
City : ORLANDO
State : FL
Zip : 32826-2940
Country : US
Telephone Number : 396-906-9062
Fax Number : 407-426-4820
Provider Business Practice Location Address
First Line : 3157 N ALAFAYA TRL
Second Line :
City : ORLANDO
State : FL
Zip : 32826-2940
Country : US
Telephone Number : 239-690-6906
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2012
Last Update Date : 01/02/2025

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