Organization
BELLAMAR MEDICAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE RIVERA (PRESIDENT)
(305) 418-3855
Entity
Organization
Contact information
Practice address
4811 NW 79TH AVE, SUITE 2, DORAL, FL 33166-5438
(305) 418-3855
Mailing address
4811 NW 79TH AVE, SUITE 2, DORAL, FL 33166-5438
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME68564
FL
Other
Enumeration date
12/15/2005
Last updated
08/22/2020
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