# MARK H MONTGOMERY MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851697023
- **Authorized official:** DR. MARK H MONTGOMERY MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (239) 495-6200

## Contact information

- **Practice address:** 9240 BONITA BEACH RD SE, SUITE 1106, BONITA SPRINGS, FL 34135-4249
- **Practice address phone:** (239) 495-6200
- **Practice address fax:** (239) 495-6247
- **Mailing address:** 9240 BONITA BEACH RD SE, SUITE 1106, BONITA SPRINGS, FL 34135-4249
- **Mailing address phone:** (239) 495-6200
- **Mailing address fax:** (239) 495-6247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | ME84347 | FL | Yes |

## Other

- **Enumeration date:** 02/04/2011
- **Last updated:** 03/22/2011