Individual
DR. C. TED MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3550 UNIVERSITY BLVD S, STE 301, JACKSONVILLE, FL 32216-4225
(904) 384-2240
(904) 448-0030
Mailing address
915 W MONROE ST, STE 200, JACKSONVILLE, FL 32204-1177
(904) 384-2240
(904) 448-0030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME10755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371200100
—
FL
Enumeration date
06/02/2005
Last updated
11/24/2009
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