Provider Demographics
NPI:1780039461
Name:BELLO, RODOLFO MODESTO SR (FNP-C)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:MODESTO
Last Name:BELLO
Suffix:SR
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2783 SW 31ST PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2940
Mailing Address - Country:US
Mailing Address - Phone:786-291-4553
Mailing Address - Fax:
Practice Address - Street 1:2783 SW 31ST PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2940
Practice Address - Country:US
Practice Address - Phone:786-291-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9312681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily