MEDICARE: DR. LEIGH NICOLE MONTEJO DNP, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	246816	NC
2	363LF0000X	Family Nurse Practitioner	ARNP9273541	FL

General Provider Information

NPI Number	:	1003195249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEIGH NICOLE MONTEJO DNP, FNP-BC

Provider Business Mailing Address
First Line	:	9527 DELANEY CREEK BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-5178
Country	:	US
Telephone Number	:
Fax Number	:	813-545-1221

Provider Business Practice Location Address
First Line	:	9527 DELANEY CREEK BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-5178
Country	:	US
Telephone Number	:	813-615-5230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2011
Last Update Date	:	06/07/2022

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