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General NPI Number Information
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NPI Number | 1194713172
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Entity Type | Individual
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Provider Name | ANDRES MONTALVO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2521 13TH ST STE D
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4103
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Country | US
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Telephone | 407-734-1273
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Fax | 866-738-7531
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Provider Business Mailing Address
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Address Line | RR 2 BOX 9
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City | SAN JUAN
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State | PR
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Zip | 00926-9767
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Country | US
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Telephone | 787-748-9252
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ACN557
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 6722
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License Number State | PR
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