Organization
BELLABREY MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY L. WILLITZER ARNP-C (OWNER)
(813) 220-6241
Entity
Organization
Contact information
Practice address
623 RAPID FALLS DR, BRANDON, FL 33511-7504
(813) 220-6241
Mailing address
623 RAPID FALLS DR, BRANDON, FL 33511-7504
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
L09000050499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307330100
—
FL
Enumeration date
05/31/2009
Last updated
05/31/2009
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