Individual provider Active NPI

Juan Carlos Montas Diaz, PA

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1265027338
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
922 Issued in PR
Practice address
12024 Magazine St Apt 9205
Orlando, FL 32828-5511
Phone
(407) 860-7388
NPI assigned
Mar 1, 2021
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 120 FL
Medical Physician Assistant 363AM0700X 922 PR Primary

Addresses

Primary practice location

12024 Magazine St Apt 9205
Orlando, FL 32828-5511

Mailing address

12024 Magazine St Apt 9205
Orlando, FL 32828-5511
Phone (407) 860-7388

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
922PRMDOccupational Therapist
120FLMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1265027338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12024 MAGAZINE ST APT 9205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328285511",
            "telephone_number": "407-860-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12024 MAGAZINE ST APT 9205",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328285511",
            "telephone_number": "407-860-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAS DIAZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "120",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PR",
            "license": "922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.