Healthcare Provider Details

I. General information

NPI: 1649660697
Provider Name (Legal Business Name): DIEGO F. MONTES M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SW SAINT LUCIE WEST BLVD
PORT SAINT LUCIE FL
34986-1766
US

IV. Provider business mailing address

900 SW SAINT LUCIE WEST BLVD
PORT SAINT LUCIE FL
34986-1766
US

V. Phone/Fax

Practice location:
  • Phone: 772-877-3591
  • Fax:
Mailing address:
  • Phone: 772-877-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME137747
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: