Provider Demographics
NPI:1598952087
Name:BELL, RODRIC J (MD)
Entity Type:Individual
Prefix:DR
First Name:RODRIC
Middle Name:J
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 SW MARTIN DOWNS BLVD
Mailing Address - Street 2:STE 287
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-6046
Mailing Address - Country:US
Mailing Address - Phone:562-508-9250
Mailing Address - Fax:
Practice Address - Street 1:5850 SE COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6420
Practice Address - Country:US
Practice Address - Phone:772-324-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79282208100000X, 2081P2900X
FL120485208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G792820Medicaid
CAG79282OtherCA LICENSE
FL120485OtherFLORIDA MEDICAL LICENSE
CAG24441Medicare UPIN
CAWG79282BMedicare PIN
CAWG79282AMedicare PIN