Leo A Montambeault Jr., PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS39669 Issued in FL

Practice address

1839 58TH St S
Gulfport, FL 33707-4154

Phone

(603) 279-8779

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003023565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6642",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032476642",
            "telephone_number": "603-279-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 58TH ST S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074154",
            "telephone_number": "603-279-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAMBEAULT",
        "first_name": "LEO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS39669",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR4761",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "R1610",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "3451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Ricardo Mendoza, D.M.D.
• Michael S Werner
• Michaelswernerdpmpa
• Mobile Therapy, Inc
• Nancy Moncada, PT
• Meghan Moyer
• Amanda Muni-Morgan, PHD
• New Vision Behavioral Health Inc
• Jane Frazier Nunnelly, M.D.
• Guy Alfred Oconnor, AP

• Pharmacist in Gulfport, FL
• Providers in Gulfport, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.