Individual
DR. DANIELE J MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9 SAN BARTOLA DR, ST AUGUSTINE, FL 32086-5767
(904) 825-4500
(904) 825-3672
Mailing address
7015 AC SKINNER PARKWAY, SUITE 1, JACKSONVILLE, FL 32256
(904) 363-2113
(904) 363-2606
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME 66664
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024339200
—
FL
01
—
25632
BCBS
FL
01
—
25632S
MEDICARE
FL
Enumeration date
04/27/2006
Last updated
05/02/2018
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