MEDICARE: DR. SOPHIA ELISA MONTOYA DPT

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	2251P0200X	Pediatric Physical Therapist	LPT-034458	AZ

General Provider Information

NPI Number	:	1053279794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOPHIA ELISA MONTOYA DPT

Provider Business Mailing Address
First Line	:	4294 S SNOWCAP CT
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-9678
Country	:	US
Telephone Number	:	480-298-2135
Fax Number	:

Provider Business Practice Location Address
First Line	:	3941 E BASELINE RD STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-2750
Country	:	US
Telephone Number	:	480-787-5387
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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