Healthcare Provider Details

I. General information

NPI: 1760056717
Provider Name (Legal Business Name): ZACHARY R MONTOTO RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 SW 131ST PLACE CT
MIAMI FL
33175-1344
US

IV. Provider business mailing address

2047 SW 131ST PLACE CT
MIAMI FL
33175-1344
US

V. Phone/Fax

Practice location:
  • Phone: 305-202-1028
  • Fax:
Mailing address:
  • Phone: 305-202-1028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25503
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: