Organization
GARY MONTSDEOCA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY MONTSDEOCA M.D. (PRESIDENT)
(863) 382-9100
Entity
Organization
Contact information
Practice address
4343 SUN N LAKE BLVD, SUITE B, SEBRING, FL 33872-2162
(863) 382-9100
(863) 382-8928
Mailing address
4343 SUN N LAKE BLVD, SUITE B, SEBRING, FL 33872-2162
(863) 382-9100
(863) 382-8928
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0024449
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
78525
MEDICARE ID
FL
Enumeration date
07/25/2008
Last updated
09/11/2008
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