Healthcare Provider Details

I. General information

NPI: 1376264903
Provider Name (Legal Business Name): MANUEL LUIS MONTERO MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 60327
BAYAMON PR
00960-6032
US

IV. Provider business mailing address

URBANIZACION MONTERREY 808 CALLE ABACOA
MAYAGUEZ PR
00680
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-3001
  • Fax:
Mailing address:
  • Phone: 787-509-0316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number024032
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: