Provider Demographics
NPI:1669874509
Name:BEAN, BELINDA (CRT)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:
Last Name:BEAN
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FRANDORSON CIR STE 203
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-2691
Mailing Address - Country:US
Mailing Address - Phone:813-645-2986
Mailing Address - Fax:866-686-7196
Practice Address - Street 1:200 FRANDORSON CIR STE 203
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2691
Practice Address - Country:US
Practice Address - Phone:813-645-2986
Practice Address - Fax:866-686-7196
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTT9167227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified