Provider Demographics
NPI:1477606903
Name:BELL, ROGER (CH)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11329 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4221
Mailing Address - Country:US
Mailing Address - Phone:727-863-1912
Mailing Address - Fax:727-869-2214
Practice Address - Street 1:11329 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4221
Practice Address - Country:US
Practice Address - Phone:727-863-1912
Practice Address - Fax:727-869-2214
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54955Medicare UPIN
FL70195Medicare ID - Type Unspecified