Individual provider Active NPI

Eduardo Montilla, MD

  • Cardiovascular Disease Physician
  • Hialeah, FL
National Provider Identifier
1376631895
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME22275 Issued in FL
Practice address
1435 W 49TH Place #201
Hialeah, FL 33012-3192
Phone
(305) 282-4155
Fax
(305) 261-0603
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME22275 FL Primary

Addresses

Primary practice location

1435 W 49TH Place #201
Hialeah, FL 33012-3192

Mailing address

1435 W 49TH Place #201
Hialeah, FL 33012-3192
Phone (305) 282-4155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040911000016 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Family PracticePractitioner - Internal Medicine 6103893052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME22275FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Selem Medical Center Corp CurrentSince Aug 31, 2004 Accepting new patients
Comprehensive Community Guidance Center Inc Past Accepting new patients
St. John Clinic Medical Center Past Accepting new patients

Locations

4800 W Flagler St
Ste 106
Coral Gables, FL 33134
Phone (305) 448-7848

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376631895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PLACE #201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123192",
            "telephone_number": "305-282-4155",
            "fax_number": "305-261-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 W 49TH PLACE #201",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123192",
            "telephone_number": "305-282-4155",
            "fax_number": "305-261-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTILLA",
        "first_name": "EDUARDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME22275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.