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Individual

ELIZABETH ANNE MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1475 NW 12TH AVE, MIAMI, FL 33136-1002
(305) 243-1000
Mailing address
1475 NW 12TH AVE, MIAMI, FL 33136-1002
(305) 243-1000

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D39599
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME145967
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
660301701
MD
Enumeration date
05/17/2006
Last updated
06/24/2020
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