Individual
AIDA SOFIA MONTENEGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 GRAND PALMS DR, PEMBROKE PINES, FL 33027-1329
(786) 259-0300
(866) 665-8671
Mailing address
15751 SHERIDAN ST # 303, FORT LAUDERDALE, FL 33331-3486
(786) 259-0300
(866) 665-8671
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA34363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA34363
LICENSE
FL
Enumeration date
10/30/2025
Last updated
10/30/2025
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