MEDICARE: MARCIA Y MONTOYA

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1578814810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA Y MONTOYA

Provider Business Mailing Address
First Line	:	PO BOX 112612
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33011-2612
Country	:	US
Telephone Number	:	305-863-2233
Fax Number	:

Provider Business Practice Location Address
First Line	:	10550 NW 77TH CT STE 308
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33016-2072
Country	:	US
Telephone Number	:	305-863-2233
Fax Number	:

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

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	09/26/2012

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Directions to “ MARCIA Y MONTOYA ” Practice Location

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