Individual
ILIANETTE MONTANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5913 WEBB RD, TAMPA, FL 33615-3219
(813) 210-5616
Mailing address
3129 GRANITE RIDGE LOOP, LAND O LAKES, FL 34638-6189
(813) 210-5616
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
9118861
FL
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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