MEDICARE: MARIELIS MONTALVO PEREZ DC

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	111N00000X	Chiropractor	CH15780	FL

General Provider Information

NPI Number	:	1598614067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIELIS MONTALVO PEREZ DC

Provider Business Mailing Address
First Line	:	1919 SE 10TH AVE APT 3131
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-3170
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8570 STIRLING RD STE 103
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8204
Country	:	US
Telephone Number	:	954-743-4133
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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