Provider Demographics
NPI:1699863183
Name:MONTANO, LUIS F (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:MONTANO
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 1:5871 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5703
Mailing Address - Country:US
Mailing Address - Phone:305-267-0333
Mailing Address - Fax:305-264-5494
Practice Address - Street 1:5871 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5703
Practice Address - Country:US
Practice Address - Phone:305-267-0333
Practice Address - Fax:305-264-5494
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060057207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF19955Medicare UPIN