Gary Montsdeoca MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0024449 Issued in FL

Legal business name

GARY MONTSDEOCA MD PA

Practice address

4343 Sun N Lake Blvd
Suite B
Sebring, FL 33872-2162

Phone

(863) 382-9100

Fax

(863) 382-8928

NPI assigned

Jul 25, 2008

Last updated

Sep 11, 2008By 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 Montsdeoca, M.D.NPI 1508899402

Title

President

Phone

(863) 382-9100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 Montsdeoca, M.D.

  • Specialist
  • Sebring, FL
  • NPI 1508899402
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1679738033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE B",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-382-9100",
            "fax_number": "863-382-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SUN N LAKE BLVD",
            "address_2": "SUITE B",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722162",
            "telephone_number": "863-382-9100",
            "fax_number": "863-382-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY MONTSDEOCA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "MONTSDEOCA",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-382-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0024449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "78525",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Delia Garcia
• Eddie Alonzo Garcia, M.D.
• Jehieli Garcia
• Brittiany Elizabeth Garrett, APRN
• Vivienne Martin Garrido, P.T.
• Brenda Smith Garza, R.N., R.D., C.D.E.
• Scott A Gasiorek, M.D.
• Belinda Gavino, M.D
• Gayatrikrupa LLC (Highlands pharmacy)
• Leighann Giacin, LPN

• Specialist in Sebring, FL
• Providers in Sebring, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.