Organization
KATHLEEN R. MONTEMAYOR, M. D., FAAP
Active
Other names
River's Edge Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN R. MONTEMAYOR M.D. (OWNER)
(727) 844-3551
Entity
Organization
Contact information
Practice address
6352 RIVER RD, NEW PORT RICHEY, FL 34652-2241
(727) 844-3551
(727) 847-0427
Mailing address
6352 RIVER RD, NEW PORT RICHEY, FL 34652-2241
(727) 844-3551
(727) 847-0427
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268389000
—
FL
01
—
34914
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/26/2005
Last updated
07/21/2022
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