Provider Demographics
NPI:1114914348
Name:MONTANTI, JENNIFER ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROSE
Last Name:MONTANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 160010
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-0001
Mailing Address - Country:US
Mailing Address - Phone:305-933-5993
Mailing Address - Fax:305-933-9415
Practice Address - Street 1:21000 NE 28TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1421
Practice Address - Country:US
Practice Address - Phone:305-933-5993
Practice Address - Fax:305-933-9415
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME901452084N0400X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270811600Medicaid
I07856Medicare UPIN