EDUARDO MONTILLA MD PA
Osteopathic Medicine at 49 Pl, Hialeah, FL

License number
Florida ME22875
Category
Osteopathic Medicine
Type
Cardiovascular Disease
Owner
Name: EDUARDO MONTILLA MD
Title: PRESIDENT
Phone: (305) 823-2710
Address
Address
1435 W 49Th Pl SUITE 201, Hialeah, FL 33012
National Provider ID: 1669626313
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EDUARDO MONTILLA, M.D., PA

1435 W 49 Pl SUITE 201, Hialeah, FL 33012

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Feb 8, 2000
Inactive since:
Apr 24, 2008
State ID:
P00000013457
Business type:
Florida Profit Corporation
President, Treasurer, Secretary, Director:
Eduardo Md Montilla (President, Treasurer, Secretary, Director), 1435 W 49 Pl SUITE 201, Hialeah, FL 33012 (Physical)
1435 W 49 St, Hialeah, FL (Physical)
Agent:
Eduardo Montilla,1435 W 49 Pl SUITE 201, Hialeah, FL 33012 (Physical)
EIN:
65-0998127

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