Provider Demographics
NPI:1821081563
Name:BELLO, MARIA B (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:B
Last Name:BELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7326
Mailing Address - Country:US
Mailing Address - Phone:352-728-6808
Mailing Address - Fax:352-728-3637
Practice Address - Street 1:4120 CORLEY ISLAND RD
Practice Address - Street 2:SUITE 500
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-8292
Practice Address - Country:US
Practice Address - Phone:352-326-6011
Practice Address - Fax:352-728-4194
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71036207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32444OtherBC/BS OF FLORIDA
FLP00390399OtherRR/PALMETTO/GBA
FL32444OtherBC/BS OF FLORIDA
G36526Medicare UPIN