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General NPI Number Information
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NPI Number | 1548836000
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Entity Type | Organization
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Legal Business Name | MONTOYA PODIATRY CENTER, LLC
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 806 N ROSE AVE
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City | KISSIMMEE
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State | FL
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Zip | 34741-4944
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Country | US
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Telephone | 407-753-4452
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Fax | 407-613-2265
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Provider Business Mailing Address
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Address Line | 806 N ROSE AVE
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City | KISSIMMEE
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State | FL
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Zip | 34741-4944
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Country | US
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Telephone | 407-753-4452
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Fax | 407-613-2265
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. EDWARD MONTOYA
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Credential | DPM
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Telephone | 908-553-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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