Provider Demographics
NPI:1194503094
Name:MMHOLDINGS74
Entity type:Organization
Organization Name:MMHOLDINGS74
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:MONTILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-556-0046
Mailing Address - Street 1:6700 SW 122ND DR
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5459
Mailing Address - Country:US
Mailing Address - Phone:786-556-0046
Mailing Address - Fax:
Practice Address - Street 1:6700 SW 122ND DR
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5459
Practice Address - Country:US
Practice Address - Phone:786-556-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty