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Organization

WEST FLORIDA MEDICAL ASSOCIATES P A

Active
Other names
Bellam Medical Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAJENDRA P BELLAM M.D. (PRESIDENT)
(352) 447-3031
Entity
Organization

Contact information

Practice address
41 N INGLIS AVE, INGLIS, FL 34449-9463
(352) 447-3031
Mailing address
PO BOX 69, 41 N. INGLIS AVE, INGLIS, FL 34449-0069
(352) 447-3031

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
ME0060472
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
660142100
FL
Enumeration date
01/31/2007
Last updated
11/09/2010
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