Provider Demographics
NPI:1033445770
Name:BELLUSH, DEBORAH MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARIE
Last Name:BELLUSH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 LEESVILLE STREET
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:517-623-6007
Mailing Address - Fax:
Practice Address - Street 1:1210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-4935
Practice Address - Country:US
Practice Address - Phone:352-787-8489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10335207Q00000X
MI5101010799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine