Provider Demographics
NPI:1427282243
Name:MONTOYA, DENNIS (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11567 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4333
Mailing Address - Country:US
Mailing Address - Phone:954-643-1020
Mailing Address - Fax:
Practice Address - Street 1:655 W. EIGHTH ST. BOX C506
Practice Address - Street 2:CLINICAL CENTER, 1ST FLOOR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:904-244-3837
Practice Address - Fax:904-244-4508
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN13457207P00000X
FLME113199207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine