Provider Demographics
NPI:1467560144
Name:BELLA-OROPILLA, SOCORRO ROSALES (MD)
Entity Type:Individual
Prefix:
First Name:SOCORRO
Middle Name:ROSALES
Last Name:BELLA-OROPILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SOCORRO
Other - Middle Name:ROSALES
Other - Last Name:BELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:502-953-4700
Mailing Address - Fax:502-772-8189
Practice Address - Street 1:2215 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-1033
Practice Address - Country:US
Practice Address - Phone:502-774-8631
Practice Address - Fax:502-772-8189
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1760591406OtherMAILHANDLERS RC PROV #
KY64296692Medicaid
KY1760591427OtherMAILHANDLERS PROV ET #
KY0562103Medicare ID - Type UnspecifiedMEDICARE ET PROV #
KYF69320Medicare UPIN
KY0561903Medicare ID - Type UnspecifiedMEDICARE HV PROV #
KYK043934Medicare PIN
KYK043933Medicare PIN
KYK043931Medicare PIN
KY64296692Medicaid
KY1760591406OtherMAILHANDLERS RC PROV #
KY0562003Medicare ID - Type UnspecifiedMEDICARE RC PROV #
KY1760591427OtherMAILHANDLERS PROV ET #
KYK043935Medicare PIN