Healthcare Provider Details

I. General information

NPI: 1326980632
Provider Name (Legal Business Name): DANIEL RAFAEL MONTESINOS AREVALO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 W 49TH PL
HIALEAH FL
33012-3113
US

IV. Provider business mailing address

10 NW 139TH ST
MIAMI FL
33168-4818
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-7774
  • Fax: 305-284-7787
Mailing address:
  • Phone: 786-486-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: