MEDICARE: DR. LELIA F MONTES 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	208000000X	Pediatrics Physician	ME0032165	FL

General Provider Information

NPI Number	:	1770558900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LELIA F MONTES MD

Provider Business Mailing Address
First Line	:	5962 BERRYHILL RD
Second Line	:
City	:	MILTON
State	:	FL
Zip	:	32570-4009
Country	:	US
Telephone Number	:	850-623-0124
Fax Number	:	850-626-9110

Provider Business Practice Location Address
First Line	:	5962 BERRYHILL RD
Second Line	:
City	:	MILTON
State	:	FL
Zip	:	32570-4009
Country	:	US
Telephone Number	:	850-623-0124
Fax Number	:	850-626-9110

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/08/2007

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