Healthcare Provider Details

I. General information

NPI: 1396299913
Provider Name (Legal Business Name): RICARDO MONTES SR. BSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 CALLE PROF AUGUSTO RODRIGUEZ ASIA BLDG. SUITE 600
SAN JUAN PR
00909-2275
US

IV. Provider business mailing address

617 CALLE BALEARES URB. PUERTO NUEVO
SAN JUAN PR
00920-5323
US

V. Phone/Fax

Practice location:
  • Phone: 787-496-0818
  • Fax: 787-982-6464
Mailing address:
  • Phone: 787-496-0818
  • Fax: 787-982-6464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: