Provider Demographics
NPI:1053541391
Name:HYGEIA MONTES MEDICAL, LLC
Entity type:Organization
Organization Name:HYGEIA MONTES MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTED MEDICAL AND NURSING SVCS
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:ALONSO
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-671-1170
Mailing Address - Street 1:13335 SW 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6544
Mailing Address - Country:US
Mailing Address - Phone:773-671-1170
Mailing Address - Fax:
Practice Address - Street 1:1470 NW 107TH AVE
Practice Address - Street 2:SUITE G
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2744
Practice Address - Country:US
Practice Address - Phone:305-594-8764
Practice Address - Fax:305-594-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9304365163WH0200X
FLOS10678207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity MedicineGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty