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General NPI Number Information
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NPI Number | 1427579754
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Entity Type | Individual
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Provider Name | ZAYDEE MONTANO RIVERA MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 21772 S ELLSWORTH LOOP RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7709
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Country | US
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Telephone | 370-048-0512
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Fax |
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Provider Business Mailing Address
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Address Line | 1684 CALLE MARQUESA
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City | PONCE
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State | PR
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Zip | 00716-0504
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Country | US
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Telephone | 480-227-2544
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 34503
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 60556
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License Number State | AZ
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