MEDICARE: MR. LIBERTAD MONTANEZ MD

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	207R00000X	Internal Medicine Physician	5175	PR

General Provider Information

NPI Number	:	1497725378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LIBERTAD MONTANEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 14441
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00916-4441
Country	:	US
Telephone Number	:	787-723-7990
Fax Number	:	787-723-7990

Provider Business Practice Location Address
First Line	:	AVE FERNANDEZ JUNCOS
Second Line	:	NO 1415
City	:	SANTURCE
State	:	PR
Zip	:	00910
Country	:	US
Telephone Number	:	787-723-7990
Fax Number	:	787-723-7990

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	01/26/2025

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