Provider Demographics
NPI:1821493321
Name:BELMORE, STEPHEN JR (LAC, DOM)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BELMORE
Suffix:JR
Gender:M
Credentials:LAC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6085 51ST TER N
Mailing Address - Street 2:
Mailing Address - City:KENNETH CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33709-3521
Mailing Address - Country:US
Mailing Address - Phone:813-313-0625
Mailing Address - Fax:
Practice Address - Street 1:6251 44TH ST N STE 6
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5900
Practice Address - Country:US
Practice Address - Phone:813-313-0625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 3324171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist