MEDICARE: DR. JOLENE R MONTANO M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME121001	FL
2	207V00000X	Obstetrics & Gynecology Physician	042897	GA
3	207V00000X	Obstetrics & Gynecology Physician	22540	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22540	OTHER	NV	STATE LIRCENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356396287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOLENE R MONTANO M.D.

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:

Provider Business Practice Location Address
First Line	:	5320 S RAINBOW BLVD STE 182
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-1896
Country	:	US
Telephone Number	:	702-255-3547
Fax Number	:	702-212-4993

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	01/17/2024

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Directions to “ DR. JOLENE R MONTANO M.D.” Practice Location

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