IVAN MONTOYA MD PA
Osteopathic Medicine at Miami Ave, Miami, FL

License number
Florida 1611842151
Category
Osteopathic Medicine
Type
Undersea and Hyperbaric Medicine
Owner
Name: SUZIE ROY
Title: MANAGER
Phone: (305) 378-2381
Address
Address
3663 S Miami Ave, Miami, FL 33133
National Provider ID: 1508178583
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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IVAN A. MONTOYA M.D., PA

Miami, FL

Status:
Inactive
Industry:
Business Services at Non-Commercial Site, Nonclassifiable Establishments
Doing business as:
Ivan Montoya
Inactive reason:
REINSTATEMENT
Registration:
Jun 23, 1987
Inactive since:
Mar 31, 1995
Addresses:
151 Cpe Florida Dr, Key Biscayne, FL 33149 (Physical)
Key Biscayne, FL 33149 (Mailing)
890 S Dixie Hwy, Miami, FL 33146
PO Box 1168, Miami, FL 33149
State ID:
M54359
Business type:
Florida Profit Corporation
President, Medical Doctor:
Ivan A. Montoya President, Medical Doctor, inactive, 151 Cpe Florida Dr, Key Biscayne, FL 33149 (Physical)
Agent:
Montoya, Ivan,151 Cpe Florida Dr, Key Biscayne, FL 33149 (Physical)
EIN:
59-2812596

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