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Organization
PRACTITIONERS AT HOME DIRECT LLC
Active
Organization
PRACTITIONERS AT HOME DIRECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY MONTANARO D.O. (MGR)
(941) 748-8400
Entity
Organization
Contact information
Practice address
1533 4TH AVE W, BRADENTON, FL 34205-5949
(941) 748-8400
(941) 748-8440
Mailing address
1533 4TH AVE W, BRADENTON, FL 34205-5949
(941) 748-8400
(941) 748-8440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS9181
FL
207RC0000X
Cardiovascular Disease Physician
ME0067842
FL
Other
Enumeration date
08/15/2012
Last updated
10/06/2015
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