Gary G Montalvo Petrovich LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

5622 Issued in PR

Legal business name

GARY G MONTALVO PETROVICH LLC

Practice address

400 Ave Domenech Ste 506
Las Americas Prof Center
San Juan, PR 00918-0000

Phone

(787) 754-8625

Fax

(787) 754-8648

NPI assigned

Jun 17, 2014

Last updated

Jun 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary G Montalvo, M.D.NPI 1437157096

Title

Dueno

Phone

(787) 754-8625

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gary George Montalvo, MD

  • Otolaryngology Physician
  • San Juan, PR
  • NPI 1437157096
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1346654324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8465",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007268465",
            "telephone_number": "787-754-8625",
            "fax_number": "787-754-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVE DOMENECH STE 506",
            "address_2": "LAS AMERICAS PROF CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009180000",
            "telephone_number": "787-754-8625",
            "fax_number": "787-754-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY G MONTALVO PETROVICH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "MONTALVO",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DUENO",
        "authorized_official_telephone_number": "787-754-8625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PR",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "5622",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luis Garraton, M.D.
• Dennis Garrett, M.D.
• Zaida E. Garrett, OTR
• Carlos Rafael Garriga Santiago
• Gustavo Adolfo Garriga-Garcia
• Claudia Elisa Garza Olivencia, MD
• Gastro Care LLC
• Gastro Centro PCS
• Gastro Class LLC
• Gastro Metabolic Services PSC

• Otolaryngology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Otolaryngology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.