Healthcare Provider Details

I. General information

NPI: 1316565104
Provider Name (Legal Business Name): FELIPE BELTRAN MONTALVO APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11430 N KENDALL DR STE 106
MIAMI FL
33176-1024
US

IV. Provider business mailing address

2768 W 60TH ST
HIALEAH FL
33016-4725
US

V. Phone/Fax

Practice location:
  • Phone: 305-279-5535
  • Fax: 305-279-2742
Mailing address:
  • Phone: 786-612-5350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11007437
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11007437
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: