Provider Demographics
NPI:1023660479
Name:BELWIN, LLC
Entity type:Organization
Organization Name:BELWIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WINONA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELMONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-390-6094
Mailing Address - Street 1:5110 E PHELPS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1062
Mailing Address - Country:US
Mailing Address - Phone:480-390-6094
Mailing Address - Fax:866-761-1196
Practice Address - Street 1:720 E MONTEBELLO AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2543
Practice Address - Country:US
Practice Address - Phone:602-279-1468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ976954Medicaid