Organization
IDALIA MONTANEZ MIRANDA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IDALIA MONTANEZ-MIRANDA PSY.D. (LICENSED PSYCHOLOGIST)
(805) 505-7210
Entity
Organization
Contact information
Practice address
130 SHIPYARD WAY UNIT 1107, ST AUGUSTINE, FL 32084-4239
(805) 505-7210
Mailing address
PO BOX 126, ST AUGUSTINE, FL 32085-0126
(805) 505-7210
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/24/2026
Last updated
06/24/2026
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