Basic Information
| Provider Information | |||||||||
| NPI: | 1326007931 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONTES | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ANTONIO | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2252 WAYCROSS ROAD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137922333 | ||||||||
| FaxNumber: | 5137420943 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 GLADES ROAD | ||||||||
| Address2: | SUITE 2A | ||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618260334 | ||||||||
| FaxNumber: | 5618260376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 08/23/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT20507 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.