Healthcare Provider Details

I. General information

NPI: 1295337475
Provider Name (Legal Business Name): GLENDA ALMEIDA MONTEJO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SW 4TH ST STE 6
CAPE CORAL FL
33991-1984
US

IV. Provider business mailing address

12019 SW 210TH ST
MIAMI FL
33177-5358
US

V. Phone/Fax

Practice location:
  • Phone: 239-910-0712
  • Fax:
Mailing address:
  • Phone: 786-720-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: