Provider Demographics
NPI:1427832989
Name:MONTEREY, JOANNA MARIE BUENVENIDA
Entity type:Individual
Prefix:
First Name:JOANNA MARIE
Middle Name:BUENVENIDA
Last Name:MONTEREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANNA MARIE
Other - Middle Name:BAUTISTA
Other - Last Name:BUENVENIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1733 COTTAGE ROSE LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5489
Mailing Address - Country:US
Mailing Address - Phone:850-938-6544
Mailing Address - Fax:
Practice Address - Street 1:1733 COTTAGE ROSE LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5489
Practice Address - Country:US
Practice Address - Phone:850-938-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9552166163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical