Active NPI
Ricardo E Perez-Montero, M.D.
- Family Medicine Physician
- Lakeland, FL
National Provider Identifier
1740288240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME-72440
- Practice address
- 4725 US Highway 98 S
Suite 102
Lakeland, FL 33812-4254 - Phone
- (863) 646-9191
- Fax
- (863) 646-5252
- NPI assigned
- Jul 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME-72440 | FL | Primary |
Addresses
Primary practice location
4725 US Highway 98 S
Suite 102
Lakeland, FL 33812-4254
Mailing address
PO Box 1387
Highland City, FL 33846-1387
Phone (863) 646-9191
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203393017 | Other | FL | TAX ID |
| ME0072440 | Other | FL | MEDICAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME-72440 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bond Urgent Care LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Winter Haven, FL
- NPI 1235641739
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363132800000",
"number": "1740288240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1387",
"city": "HIGHLAND CITY",
"state": "FL",
"postal_code": "338461387",
"telephone_number": "863-646-9191",
"fax_number": "863-646-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 US HIGHWAY 98 S",
"address_2": "SUITE 102",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338124254",
"telephone_number": "863-646-9191",
"fax_number": "863-646-5252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ-MONTERO",
"first_name": "RICARDO",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-08",
"last_updated": "2013-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME-72440",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "203393017",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "ME0072440",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.