Basic Information
| Provider Information | |||||||||
| NPI: | 1558860569 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELCHER | ||||||||
| FirstName: | DEANGELO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 NW 2ND AVE UNIT 11376 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331010198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054179001 | ||||||||
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| Practice Location | |||||||||
| Address1: | 419 W 49TH ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330123657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8558326727 | ||||||||
| FaxNumber: | 7726759100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2018 | ||||||||
| LastUpdateDate: | 02/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 374700000X | FL | Y | Nursing Service Related Providers | Technician |
No ID Information.