MEDICARE: DR. ILDEFONSO C. MONTEIRO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	010122334	VA

General Provider Information

NPI Number	:	1386605111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILDEFONSO C. MONTEIRO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 740209
Second Line	:	DEPT 1041
City	:	ATLANTA
State	:	GA
Zip	:	30374-0209
Country	:	US
Telephone Number	:	941-360-1566
Fax Number	:	941-358-9818

Provider Business Practice Location Address
First Line	:	2621 GROVE AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-4300
Country	:	US
Telephone Number	:	804-254-5100
Fax Number	:	804-254-5187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	05/05/2009

Similar Medicare Providers

1952362857 — DR. WILLIAM FRANCIS BROWN M.D.
Practice Location Address:

2621 GROVE AVENUE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax: 804-254-5187

1780645325 — CHERYL WAGNER HITE CRNA
Practice Location Address:

2621GROVE AVE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax: 804-254-5187

1902868128 — JAMES JUDE NEIMAN CRNA
Practice Location Address:

2621 GROVE AVE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax: 804-254-5187

1275595878 — SUSAN MOXLEY VAN MANEN CRNA
Practice Location Address:

2621 GROVE AVE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax:

1043265523 — CYNTHIA LEE KRANITZKY CRNA
Practice Location Address:

2621 GROVE AVENUE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax:

1841245180 — DR. SUNG GOHN PARK M.D.
Practice Location Address:

2621 GROVE AVENUE
RICHMOND, VA
23220-4300

Practice Phone: 804-254-5100
Practice Fax:

Directions to “ DR. ILDEFONSO C. MONTEIRO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.