MEDICARE: MS. ANGELICA MARIA CANO MONTOYA 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	174400000X	Specialist	13120	PR
2	208000000X	Pediatrics Physician	ME138976	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13120	OTHER	PR	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487634937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELICA MARIA CANO MONTOYA M.D.

Provider Business Mailing Address
First Line	:	1877 FORTUNE RD
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-4428
Country	:	US
Telephone Number	:	407-943-8600
Fax Number	:	407-932-5140

Provider Business Practice Location Address
First Line	:	109 N DOVERPLUM AVENUE
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34758-3475
Country	:	US
Telephone Number	:	407-943-8600
Fax Number	:	407-943-8640

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	11/02/2022

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