Provider Demographics
NPI:1245335926
Name:BILELLO, VINCENT A (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:BILELLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1440 CORAL RIDGE DR
Mailing Address - Street 2:#308
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:954-746-9600
Mailing Address - Fax:954-746-0506
Practice Address - Street 1:3801 N UNIVERSITY DR
Practice Address - Street 2:S501
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-746-9600
Practice Address - Fax:954-746-0506
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLCH0003962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T95191Medicare UPIN