Healthcare Provider Details

I. General information

NPI: 1235822594
Provider Name (Legal Business Name): ARIEL MONTANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11310 LEGACY AVE
PALM BEACH GARDENS FL
33410-3658
US

IV. Provider business mailing address

275 W 64TH ST
HIALEAH FL
33012-2667
US

V. Phone/Fax

Practice location:
  • Phone: 561-799-1490
  • Fax:
Mailing address:
  • Phone: 786-203-3727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA24504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: