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Individual

MIGUEL MONTIEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5901 W LINEBAUGH AVE, TAMPA, FL 33624-5097
(971) 336-4392
Mailing address
4238 PLAYER CIR, ORLANDO, FL 32808-2212
(971) 336-4392

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
L19000008366
FL

Other

Enumeration date
06/11/2019
Last updated
11/27/2023
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