Provider Demographics
NPI:1891962932
Name:BELLO, JACLYN SALVADOR
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:SALVADOR
Last Name:BELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:SALVADOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, RNFA
Mailing Address - Street 1:9055 SW 87TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2306
Mailing Address - Country:US
Mailing Address - Phone:941-321-9035
Mailing Address - Fax:
Practice Address - Street 1:9055 SW 87TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2306
Practice Address - Country:US
Practice Address - Phone:305-270-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9169182163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse