Provider Demographics
NPI:1396367678
Name:BELLO, DESIREE M (RDMS)
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:M
Last Name:BELLO
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11917 MYRTLE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3143
Mailing Address - Country:US
Mailing Address - Phone:813-737-3145
Mailing Address - Fax:
Practice Address - Street 1:11917 MYRTLE ROCK DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-3143
Practice Address - Country:US
Practice Address - Phone:813-737-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-10
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL192222085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound