Individual provider Active NPI

Michael Montejo, PHARMD

  • Pharmacist
  • West Palm Beach, FL
National Provider Identifier
1316481963
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS55183 Issued in FL
Practice address
2820 Flamango Lake Dr
West Palm Beach, FL 33406-4308
Phone
(786) 514-6983
NPI assigned
Dec 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS55183 FL Primary

Addresses

Primary practice location

2820 Flamango Lake Dr
West Palm Beach, FL 33406-4308

Mailing address

2820 Flamango Lake Dr
West Palm Beach, FL 33406-4308
Phone (786) 514-6983

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS55183FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1316481963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 FLAMANGO LAKE DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334064308",
            "telephone_number": "786-514-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 FLAMANGO LAKE DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334064308",
            "telephone_number": "786-514-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEJO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS55183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.