Organization · NPI-2

R Edward Montejo MD PA

Psychiatry & Neurology, Neurology · Fort Pierce, FL

NPI number1003095274
StatusActive
Last updated in NPPESJan 25, 2012

Details

NPI
1003095274
Entity type
Organization (NPI-2)
Legal business name
R Edward Montejo MD PA
Organization subpart
No
Enumeration date
Oct 24, 2007
Last updated
Jan 25, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, NeurologyME55755FLYes

Practice location

942 Seaway Dr
Fort Pierce, FL 34949-3123

Phone 772-467-0348 · Fax 772-466-8286

Mailing address

942 Seaway Dr
Fort Pierce, FL 34949-3123

Phone 772-467-0348 · Fax 772-466-8286

Authorized official

Marcy Montejo
Account Manager
7724670348

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