NPIMap

Organization Active NPI

Jesus Montesano MD LLC

  • Medical Specialty Clinic/Center
  • Hialeah, FL
National Provider Identifier
1043563513
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME 57047 Issued in FL
Legal business name
JESUS MONTESANO MD LLC
Practice address
664 E 25TH St
Suite 101
Hialeah, FL 33013-3805
Phone
(305) 835-7625
Fax
(305) 835-0550
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Joseph N De Vera
Title
Ra
Phone
(786) 200-8305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X ME 57047 FL Primary

Addresses

Primary practice location

664 E 25TH St
Suite 101
Hialeah, FL 33013-3805

Mailing address

1000 NW 57TH CT Ste 400
Miami, FL 33126-3292
Phone (305) 649-8100

Other identifiers 1

IdentifierTypeStateIssuer
064494300MedicaidFL

Other names 1

  • Jesus Montesano MD PA Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

664 E 25th St
Ste 101
Hialeah, FL 33013
Phone (305) 835-7625

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1043563513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NW 57TH CT STE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263292",
            "telephone_number": "305-649-8100",
            "fax_number": "305-835-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 E 25TH ST",
            "address_2": "SUITE 101",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133805",
            "telephone_number": "305-835-7625",
            "fax_number": "305-835-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS MONTESANO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "DE VERA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "RA",
        "authorized_official_telephone_number": "786-200-8305"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME 57047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064494300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jesus Montesano MD PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jesus Montesano MD PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.