Provider Demographics
NPI:1336227842
Name:BELMONTE, WINONA (MD)
Entity Type:Individual
Prefix:
First Name:WINONA
Middle Name:
Last Name:BELMONTE
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 1:3300 N TRIUMPH BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6475
Mailing Address - Country:US
Mailing Address - Phone:801-821-2781
Mailing Address - Fax:801-901-1194
Practice Address - Street 1:2355 E CAMELBACK RD STE 618
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-9040
Practice Address - Country:US
Practice Address - Phone:480-626-2024
Practice Address - Fax:480-210-0230
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ341552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ976954Medicaid
AZ976954Medicaid
AZ106613Medicare ID - Type Unspecified