Montanez-Miranda, Idalia

Montanez-Miranda, Idalia is an sole proprietor health care provider with primary practice located at 130 Shipyard Way Unit 1107 , St Augustine FL 32084-4239. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Montanez-Miranda, Idalia can be contacted via phone (805) 505-7210.

Contact Information

Primary practice address
130 Shipyard Way Unit 1107 St Augustine FL 32084-4239
Phone: (805) 505-7210
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY60898484 Washington
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY60898484 Washington

Profile Details

NPI number 1942589296
LBN Legal business name Montanez-Miranda, Idalia
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 4th, 2011
Last updated Jun 12th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942589296 NPPES
Washington Other PY60898484 DEPARTMENT OF HEALTH

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