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Individual

DR. RAFAEL G. MONTALVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Mailing address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME81668
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME81668
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03203
BCBS
FL
01
050083022
RAILROAD MEDICARE
05
2619989 00
FL
01
XXX-XX-3068
CHAMPUS / TRICARE SOUTH REGION
Enumeration date
07/25/2006
Last updated
09/21/2023
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