Provider Demographics
NPI:1073676235
Name:BELLIDO, ADRIAN DAVID JR (PA)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:DAVID
Last Name:BELLIDO
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 CATANIA WAY
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4314
Mailing Address - Country:US
Mailing Address - Phone:561-795-2669
Mailing Address - Fax:
Practice Address - Street 1:2720 10TH AVE N STE 100
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3100
Practice Address - Country:US
Practice Address - Phone:561-540-4446
Practice Address - Fax:561-540-4430
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102649363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2927942 00Medicaid
FLAB147ZMedicare Oscar/Certification
FL2927942 00Medicaid