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General NPI Number Information
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NPI Number | 1851132765
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Entity Type | Individual
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Provider Name | MONTSERRAT CAROLINA RODRIGUEZ LANTIGUA PA
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 207 PARK PLACE BLVD STE 4
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City | KISSIMMEE
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State | FL
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Zip | 34741-2373
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Country | US
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Telephone | 689-677-2673
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Fax |
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Provider Business Mailing Address
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Address Line | 207 PARK PLACE BLVD STE 4
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City | KISSIMMEE
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State | FL
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Zip | 34741-2373
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Country | US
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Telephone | 689-677-2673
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | P.A-001987
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TPPA738
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PACN51
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License Number State | FL
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