Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 16635 | PR |
N | 208G00000X | Cardiothoracic Vascular Surgeon | A99902 | CA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | ME135473 | FL |
NPI | 1013185230 |
---|---|
Provider Name | Dr. Jose Alberto Montalvo Fitzpatrick |
First Address | Watertown, MA 02472-4522 |
Second Address | Rockledge, FL 32955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2008 |
Last Update Date | 20/06/2018 |