Provider Demographics
NPI:1265321988
Name:MONTILLER RUZ, ORESTES
Entity type:Individual
Prefix:
First Name:ORESTES
Middle Name:
Last Name:MONTILLER RUZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 N STORY RD # 825A
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-5974
Mailing Address - Country:US
Mailing Address - Phone:281-492-4853
Mailing Address - Fax:
Practice Address - Street 1:2247 PALM BEACH LAKES BLVD FL 33409
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3470
Practice Address - Country:US
Practice Address - Phone:281-492-8453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9619685163W00000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse