MEDICARE: MISAEL MONTERO

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	363L00000X	Nurse Practitioner	11006578	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477138220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISAEL MONTERO

Provider Business Mailing Address
First Line	:	2229 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2040
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:	786-377-5525

Provider Business Practice Location Address
First Line	:	2229 SHERIDAN ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2040
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:	786-377-5525

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

Provider Enumeration Date	:	03/12/2021
Last Update Date	:	11/16/2022

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Directions to “ MISAEL MONTERO ” Practice Location

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