Healthcare Provider Details

I. General information

NPI: 1366634701
Provider Name (Legal Business Name): TALIA LILIANA BELMONT MONTEVERDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE, ML 5026
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE, ML 5026
CINCINNATI OH
45229-3039
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7722
  • Fax: 513-636-3737
Mailing address:
  • Phone: 513-636-7722
  • Fax: 513-636-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.096314
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: