Healthcare Provider Details

I. General information

NPI: 1164415782
Provider Name (Legal Business Name): MONTE BELLO MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 E LOHMAN AVE STE 4
LAS CRUCES NM
88011-8296
US

IV. Provider business mailing address

3851 E LOHMAN AVE STE 4
LAS CRUCES NM
88011-8296
US

V. Phone/Fax

Practice location:
  • Phone: 575-993-5611
  • Fax: 575-483-7224
Mailing address:
  • Phone: 575-993-5611
  • Fax: 575-483-7224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA DELGADO
Title or Position: CEO
Credential:
Phone: 575-993-5611