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General NPI Number Information
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NPI Number | 1992015184
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Entity Type | Organization
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Legal Business Name | PIERE JACOB MONTROSE M D PA
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 5762 OKEECHOBEE BLVD SUITE 607
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4343
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Country | US
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Telephone | 772-871-7800
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Fax | 772-871-7822
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Provider Business Mailing Address
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Address Line | PO BOX 12717
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City | FORT PIERCE
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State | FL
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Zip | 34979-2717
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Country | US
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Telephone | 772-871-7800
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Fax | 772-871-7822
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Authorized Official
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Title or Position | OWNER
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Name | PIERRE JACOB MONTROSE
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Credential | MD
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Telephone | 772-871-7800
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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 | ME69838
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License Number State | FL
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