Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | ME048965 | FL |
NPI | 1023003290 |
---|---|
Provider Name | Mr. Mont J Cartwright |
First Address | Kissimmee, FL 34744-4570 |
Second Address | Kissimmee, FL 34744-4570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 04/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046082600 | (05) | FL |
180046058 | RR MEDICARE (01) | FL |
18724 | BCBS (01) | FL |