Healthcare Provider Details

I. General information

NPI: 1164835088
Provider Name (Legal Business Name): LISBET M MONTERO OTD, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 VIEWPOINT DR
LEHIGH ACRES FL
33972-1031
US

IV. Provider business mailing address

3721 19TH ST SW
LEHIGH ACRES FL
33976-3317
US

V. Phone/Fax

Practice location:
  • Phone: 786-444-0244
  • Fax:
Mailing address:
  • Phone: 786-444-0244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT19971
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: