Provider Demographics
NPI:1063104024
Name:DANIEL MONTENEGRO, LLC
Entity type:Organization
Organization Name:DANIEL MONTENEGRO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:MONTENEGRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-804-6396
Mailing Address - Street 1:3683 S MIAMI AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4224
Mailing Address - Country:US
Mailing Address - Phone:305-280-9491
Mailing Address - Fax:305-290-3714
Practice Address - Street 1:3683 S MIAMI AVE STE 260
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4224
Practice Address - Country:US
Practice Address - Phone:305-804-6396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty