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General NPI Number Information
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NPI Number | 1386893030
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Entity Type | Individual
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Provider Name | MARTHA ELISA MONTERO
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Gender | Female
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 1670 EAGLE HARBOR PKWY
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City | ORANGE PARK
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State | FL
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Zip | 32003-4820
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Country | US
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Telephone | 904-644-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 EAGLE HARBOR PKWY
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City | ORANGE PARK
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State | FL
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Zip | 32003-4820
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Country | US
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Telephone | 904-644-0700
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9218889
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9218889
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License Number State | FL
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