Provider Demographics
NPI:1972241784
Name:BELLO, KRYSTINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:KRYSTINA
Middle Name:MARIE
Last Name:BELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11767 SW 90TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2172
Mailing Address - Country:US
Mailing Address - Phone:786-374-1474
Mailing Address - Fax:
Practice Address - Street 1:11767 SW 90TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2172
Practice Address - Country:US
Practice Address - Phone:786-374-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst