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Provider Information for 1992798680

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. MIGUEL A MONTOYA MD

Gender: MALE

Individual NPI: 1992798680

Calendar   Last Updated:  2021-05-10
  Certification Date:  2021-05-10

Details

Name Value
NPI 1992798680
Enumeration Date 2005-08-26
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2511 W VIRGINIA AVE
TAMPA, FL 33607-6310
United States

Phone: 813-270-6133 | Fax: 813-350-0053
View Map External Link
Primary Practice Address 2511 W VIRGINIA AVE
TAMPA, FL 33607-6310
United States

Phone: 813-270-6133 | Fax: 813-350-0053
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 003087300
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME 105157
No 207RG0300X - Internal Medicine Geriatric Medicine FL ME 105157
No 207RH0002X - Internal Medicine Hospice and Palliative Medicine FL ME 105157