Basic Information
| Provider Information | |||||||||
| NPI: | 1336730597 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONTUFAR | ||||||||
| FirstName: | ZARA | ||||||||
| MiddleName: | JANNINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20731 NE 4TH PL APT 102 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331791865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7869085313 | ||||||||
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| Practice Location | |||||||||
| Address1: | 240 CRANDON BLVD STE 212 | ||||||||
| Address2: | |||||||||
| City: | KEY BISCAYNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331491597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053616232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2021 | ||||||||
| LastUpdateDate: | 08/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2020092643 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.