Healthcare Provider Details

I. General information

NPI: 1558397737
Provider Name (Legal Business Name): ALBERTO D GIL DE MONTES BS, MS, CNMT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7775 NW 48TH ST SUITE 150
DORAL FL
33166-5468
US

IV. Provider business mailing address

7044 NW 115TH CT
DORAL FL
33178-5527
US

V. Phone/Fax

Practice location:
  • Phone: 305-594-2881
  • Fax: 305-594-2871
Mailing address:
  • Phone: 786-252-4892
  • Fax: 305-594-2871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number56261
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: