1851725907 NPI number — BELTONE ORLANDO, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851725907 NPI number — BELTONE ORLANDO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELTONE ORLANDO, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BELTONE FLORIDA
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851725907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
931 JEFFERSON BLVD
Provider Second Line Business Mailing Address:
STE. 2001
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02886-2234
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-298-2855
Provider Business Mailing Address Fax Number:
904-298-2857

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
990 N STATE ROAD 434
Provider Second Line Business Practice Location Address:
SUITE 1144
Provider Business Practice Location Address City Name:
ALTAMONTE SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32714-7035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-298-2855
Provider Business Practice Location Address Fax Number:
904-298-2857
Provider Enumeration Date:
08/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BARBER
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
INSURANCE MANAGER
Authorized Official Telephone Number:
904-298-2855

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  AS3349 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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