Provider Demographics
NPI:1508936022
Name:BELLON, CLARISSA BRIDGETT (RN,CDE)
Entity Type:Individual
Prefix:MS
First Name:CLARISSA
Middle Name:BRIDGETT
Last Name:BELLON
Suffix:
Gender:F
Credentials:RN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W 68TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1801
Mailing Address - Country:US
Mailing Address - Phone:305-496-1296
Mailing Address - Fax:786-639-1608
Practice Address - Street 1:2001 W 68TH ST
Practice Address - Street 2:PALMETTO GENERAL HOSPITAL-DIABETES CENTER
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1801
Practice Address - Country:US
Practice Address - Phone:305-496-1296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1233812163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator