MEDICARE: GILBERT JOSEPH MONTANO FNP-BC

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	AP2668	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN060694	OTHER	AZ	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821286915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT JOSEPH MONTANO FNP-BC

Provider Business Mailing Address
First Line	:	410 N MALACATE ST
Second Line	:
City	:	AJO
State	:	AZ
Zip	:	85321-2254
Country	:	US
Telephone Number	:	520-387-5651
Fax Number	:	520-387-6063

Provider Business Practice Location Address
First Line	:	14574 S SUNLAND GIN RD
Second Line	:
City	:	ARIZONA CITY
State	:	AZ
Zip	:	85123
Country	:	US
Telephone Number	:	520-387-5651
Fax Number	:	520-494-0130

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

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	07/02/2025

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