Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN0014898 | FL |
NPI | 1003843426 |
---|---|
Provider Name | Dr. Kevin Louis Monteleone |
First Address | Tampa, FL 33629-5745 |
Second Address | Tampa, FL 33629-5745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |