Provider Demographics
NPI:1760649941
Name:GOMEZ-BELLO, IVETTE MARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:MARIA
Last Name:GOMEZ-BELLO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6567 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1843
Mailing Address - Country:US
Mailing Address - Phone:305-264-2666
Mailing Address - Fax:305-264-9400
Practice Address - Street 1:6567 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1843
Practice Address - Country:US
Practice Address - Phone:305-264-2666
Practice Address - Fax:305-264-9400
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN128551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice