Doctor Name: | VICTOR M MONTES JORDAN |
NPI Number: | 1225465461 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M,D. |
License Number: | 28450 |
Business Practice Address: | 710 Wickham Lakes Dr Viera, FL - 329402200 |
Business Phone Number: | 3214128822 |
Business Fax Number: | |
Mailing Address: | 710 Wickham Lakes Dr, VIERA |
State: | FL |
Postal Code: | 329402200 |
Phone Number: | 3214128822 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2013 |
NPI Last Update Date: | 10/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080P0207X |
License Number: | 28450 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Pediatric Hematology-Oncology |
Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |