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Individual

MS. STEPHANIE L BELLAMY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3056 W. 1ST STREET, JACKSONVILLE, FL 32254-2539
(904) 388-7086
(904) 388-7086
Mailing address
3056 W. 1ST STREET, JACKSONVILLE, FL 32254-2539
(904) 388-7086
(904) 388-7086

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10793
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142571400
FL
01
142571496
MED-WAIVER
FL
05
310400000X
FL
Enumeration date
12/02/2010
Last updated
03/14/2017
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