Provider Demographics
NPI:1295051134
Name:MONTEIRO, ROSEBEL (MD)
Entity type:Individual
Prefix:
First Name:ROSEBEL
Middle Name:
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S AUDUBON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4217
Mailing Address - Country:US
Mailing Address - Phone:813-877-1415
Mailing Address - Fax:
Practice Address - Street 1:602 S AUDUBON AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4217
Practice Address - Country:US
Practice Address - Phone:813-877-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136684208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery