Provider Demographics
NPI:1174814743
Name:BEHRENS BELLO, VICENTE ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:VICENTE
Middle Name:ALBERTO
Last Name:BEHRENS BELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:305-674-2345
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD STE 2454
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2948
Practice Address - Country:US
Practice Address - Phone:305-674-2345
Practice Address - Fax:305-674-9723
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124191207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL150QLOtherFLORIDA BLUE
FL015087300Medicaid
FL150QLOtherFLORIDA BLUE