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General NPI Number Information
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NPI Number | 1114168044
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Entity Type | Individual
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Provider Name | SYLVIA MARIE VIVES-MONTANO PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 11400 N KENDALL DR STE 204
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City | MIAMI
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State | FL
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Zip | 33176-1029
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Country | US
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Telephone | 305-279-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 11400 N KENDALL DR STE 204
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City | MIAMI
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State | FL
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Zip | 33176-1029
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Country | US
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Telephone | 305-279-4222
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Fax | 305-501-2031
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9104725
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License Number State | FL
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