Provider Demographics
NPI:1588014088
Name:BELLEVUE, GUERLYNE
Entity Type:Individual
Prefix:MS
First Name:GUERLYNE
Middle Name:
Last Name:BELLEVUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 N WILLIAMSON BLVD APT 6204
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5227
Mailing Address - Country:US
Mailing Address - Phone:386-216-6184
Mailing Address - Fax:386-206-1145
Practice Address - Street 1:2351 N WILLIAMSON BLVD APT 6204
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5227
Practice Address - Country:US
Practice Address - Phone:386-216-6184
Practice Address - Fax:386-206-1145
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-15
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 222Q00000X, 252Y00000X
FLRBT-21-166687106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No174400000XOther Service ProvidersSpecialist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No252Y00000XAgenciesEarly Intervention Provider Agency