SHACOYA MONTGOMERY


Address: 3909 Sandhill Crane Dr, Lakeland, FL 33811-1862
Phone: 8636175840

SHACOYA MONTGOMERY (NPI# 1316416381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316416381
Entity Type Individual
Full Name SHACOYA MONTGOMERY
Practice Address 3909 Sandhill Crane Dr
Lakeland
FL 33811-1862
Practice Telephone 8636175840
Mailing Telephone 8636175840
Enumeration Date 2018-11-19
Last Update Date 2018-11-19
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD1600X Clinic/Center
Specialization: Developmental Disabilities
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
FL 824729967 05

Office Location

Street Address 3909 SANDHILL CRANE DR
City LAKELAND
State FL
Zip Code 33811-1862

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497229926 Awesome Angels of Change LLC Clinic/Center 3909 Sandhill Crane Dr, Lakeland, FL 33811-1862 2019-01-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952910200 Darielle Shanette Berrian Assisted Living Facility 1548 Georgetown Dr, Lakeland, FL 33811 2020-07-23
1760991012 Gregory Clark Driver 1091 Old South Dr, Lakeland, FL 33811 2017-09-28
1356870703 Jeanette Michelle Edmonds Psychologist 4231 S. Pipkin Rd., Building 2 - Mental Health/behavioral Sciences, Lakeland, FL 33811 2017-06-08
1932353406 Monique L Lisowski Dietitian, Registered 4231 South Pipkin Road, Lakeland, FL 33811 2008-11-11
1306987029 Lifesavers Home Respiratory, Inc. Durable Medical Equipment & Medical Supplies 2525 Drane Field Rd, Suite 14, Lakeland, FL 33811 2007-02-08
1518010305 Kirk Randall Smith Nurse Practitioner 1475 Airport Road, Lakeland, FL 33811 2007-01-18
1578568176 Southeastern Medical Supply Inc Durable Medical Equipment & Medical Supplies 3615 Century Blvd, Unit #1, Lakeland, FL 33811 2005-06-20
1225279318 Affordable Transport Inc. Non-emergency Medical Transport (VAN) 3706 Dmg Dr, Lakeland, FL 33811-1043 2009-03-18
1457747875 Candace Borders Physical Therapy Assistant 3225 Thoroughbred Loop N, Lakeland, FL 33811-1078 2015-04-13
1962849729 Angelica Monteverde Counselor 3121 Filly Ln, Lakeland, FL 33811-1080 2013-06-03
Find all providers in zip 33811

Taxonomy Information

Taxonomy Code 261QD1600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Developmental Disabilities

Taxonomy Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366071995 Better Quest Healthcare Agency Clinic/Center 8083 Darlington Cir, Lakeland, FL 33809-6841 2020-04-06
1033753876 Sanergy Administrative and Home Care Services Clinic/Center 722 Saratoga Ave, Lakeland, FL 33815-1279 2019-11-05
1962044602 Helping Everyone Spiritually LLC Clinic/Center 7225 Twin Cedar Ln, Lakeland, FL 33810-2183 2019-10-15
1831746593 Bobbie Dashercare LLC Clinic/Center 4006 Golf Village Loop Apt 2, Lakeland, FL 33809-4056 2019-08-19
1306323340 Sandrene Smart Clinic/Center 625 Commerce Dr. (suite 103), Lakeland, FL 33813 2018-07-23
1629577382 Dane Anthony Jones Clinic/Center 7833 Manor Dr, Lakeland, FL 33810-1380 2018-02-08
1235650029 Lynn Tatyana Joseph Clinic/Center 921 E Parker St Ste 4, Lakeland, FL 33801-1901 2017-06-30
1730252479 South Georgia Csb Clinic/Center 321 W Brantley, Lakeland, GA 31635 2006-11-17
1376190025 C&g's Grace Place LLC Clinic/Center 6763 Krenson Oaks Cir, Lakeland, FL 33810-2157 2019-08-19
1497229926 Awesome Angels of Change LLC Clinic/Center 3909 Sandhill Crane Dr, Lakeland, FL 33811-1862 2019-01-17
Find all providers in LAKELAND

Competitor

Search similar providers

City LAKELAND
Zip Code 33811

Improve Information

Please comment or provide details below to improve the information on SHACOYA MONTGOMERY.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches