Provider Demographics
NPI:1679709695
Name:BELLORIN, SUZETTE FAWZIA (NP)
Entity Type:Individual
Prefix:MS
First Name:SUZETTE
Middle Name:FAWZIA
Last Name:BELLORIN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:786-535-7200
Mailing Address - Fax:786-535-7294
Practice Address - Street 1:401 OPA LOCKA BLVD
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3528
Practice Address - Country:US
Practice Address - Phone:786-535-7200
Practice Address - Fax:786-535-7294
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY335868363LF0000X
FLARNP9339659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily