Provider Demographics
NPI:1891195988
Name:ROSA BELLOTA MD PC INC
Entity Type:Organization
Organization Name:ROSA BELLOTA MD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLOTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-987-6174
Mailing Address - Street 1:5940 S RAINBOW BLVD STE 2003
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2540
Mailing Address - Country:US
Mailing Address - Phone:702-987-6174
Mailing Address - Fax:702-253-1468
Practice Address - Street 1:5940 S RAINBOW BLVD STE 2003
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2540
Practice Address - Country:US
Practice Address - Phone:702-987-6174
Practice Address - Fax:702-253-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty