MEDICARE: EDUARDO A MONTADAS, DC

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	111N00000X	Chiropractor	CH8008	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	53942	OTHER	FL	BC/BS

General Provider Information

NPI Number	:	1235370875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDUARDO A MONTADAS, DC

Provider Business Mailing Address
First Line	:	15426 NW 77TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5803
Country	:	US
Telephone Number	:	305-558-4650
Fax Number	:	480-393-5972

Provider Business Practice Location Address
First Line	:	15426 NW 77TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5803
Country	:	US
Telephone Number	:	305-558-4650
Fax Number	:	480-393-5972

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. EDUARDO ALBERTO MONTADAS
Credential	:	D.C
Telephone Number	:	305-558-4650

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/19/2010

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