Individual
MARIANA LEE MONTERO JAQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2402 WINNEBAGO ST, MADISON, WI 53704-5341
(608) 242-6855
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77648-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2020
Last updated
08/04/2023
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