MEDICARE: DENNIS MONTFORT APRN

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	363LF0000X	Family Nurse Practitioner	9330576	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	:	1497204150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS MONTFORT APRN

Provider Business Mailing Address
First Line	:	216 S PINE AVE
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4838
Country	:	US
Telephone Number	:	352-476-4584
Fax Number	:	866-452-2717

Provider Business Practice Location Address
First Line	:	216 S PINE AVE
Second Line	:
City	:	INVERNESS
State	:	FL
Zip	:	34452-4838
Country	:	US
Telephone Number	:	352-476-4584
Fax Number	:	866-452-2717

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

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	02/17/2025

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Directions to “ DENNIS MONTFORT APRN” Practice Location

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