MEDICARE: DR. ESTEFANY MONTANA

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	1223G0001X	General Practice Dentistry	DN29084	FL

General Provider Information

NPI Number	:	1093554420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESTEFANY MONTANA

Provider Business Mailing Address
First Line	:	870 W 36TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5164
Country	:	US
Telephone Number	:	786-768-6499
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 N MIAMI BEACH BLVD
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3701
Country	:	US
Telephone Number	:	305-907-2186
Fax Number	:

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

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	07/10/2025

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