MEDICARE: MARIBEL MONTENEGRO

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	247200000X	Other Technician	M535540666380	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	:	1770022204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL MONTENEGRO

Provider Business Mailing Address
First Line	:	2216 ENSENADA TER
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33327-2243
Country	:	US
Telephone Number	:	305-746-8047
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 VILLAGE LAKE DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-1632
Country	:	US
Telephone Number	:	305-746-8047
Fax Number	:

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

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	03/24/2026

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Directions to “ MARIBEL MONTENEGRO ” Practice Location

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