Individual provider Active NPI

Jimmy Montealegre Jr., RT, CPHT

  • Radiography Radiologic Technologist
  • Ocoee, FL
National Provider Identifier
1225322506
Registry record updated Jun 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
CRT74381 Issued in FL
Practice address
10000 W Colonial Dr
Ocoee, FL 34761-3400
Phone
(407) 296-1169
NPI assigned
Jun 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X RPT769 FL
Radiography Radiologic Technologist 2471C3402X CRT74381 FL Primary

Addresses

Primary practice location

10000 W Colonial Dr
Ocoee, FL 34761-3400

Mailing address

3126 Anquilla Ave
Clermont, FL 34711-5297
Phone (407) 616-8803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RPT769FLMDPharmacy Technician
CRT74381FLMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307145600000",
    "number": "1225322506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3126 ANQUILLA AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347115297",
            "telephone_number": "407-616-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613400",
            "telephone_number": "407-296-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEALEGRE",
        "first_name": "JIMMY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RT, CPHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-04",
        "last_updated": "2011-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "FL",
            "license": "RPT769",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "FL",
            "license": "CRT74381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2011; 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.