MEDICARE: ALEJANDRINA MONTAS PA

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	363A00000X	Physician Assistant	PA9105365	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC702Y	OTHER	FL	MEDICARE

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
3	Y0H8P	OTHER	FL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871818294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRINA MONTAS PA

Provider Business Mailing Address
First Line	:	8360 SIERRA MEADOWS BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-7328
Country	:	US
Telephone Number	:	239-624-8500
Fax Number	:	239-624-8501

Provider Business Practice Location Address
First Line	:	8360 SIERRA MEADOWS BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-7328
Country	:	US
Telephone Number	:	239-624-8500
Fax Number	:	239-624-8501

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

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	07/21/2022

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Directions to “ ALEJANDRINA MONTAS PA” Practice Location

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