# BELVEDERE MEDISPA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235722851
- **Authorized official:** LINETTE EKE NP (COFOUNDER)
- **Authorized official phone:** (443) 928-7707

## Contact information

- **Practice address:** 524 E BELVEDERE AVE STE A, BALTIMORE, MD 21212-3701
- **Practice address phone:** (443) 438-7168
- **Mailing address:** 524 E BELVEDERE AVE STE A, BALTIMORE, MD 21212-3701
- **Mailing address phone:** (443) 438-7168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |
| 333600000X | Pharmacy | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/15/2021
- **Last updated:** 04/19/2021