Provider Demographics
NPI:1700807054
Name:ALMOJERA, BELLE BUCCAT (MD)
Entity Type:Individual
Prefix:DR
First Name:BELLE
Middle Name:BUCCAT
Last Name:ALMOJERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 TIMUQUANA RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-8054
Mailing Address - Country:US
Mailing Address - Phone:904-771-5910
Mailing Address - Fax:904-771-1401
Practice Address - Street 1:5601 TIMUQUANA RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-8054
Practice Address - Country:US
Practice Address - Phone:904-771-5910
Practice Address - Fax:904-771-1401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29414208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL059239100Medicaid
FL15419Medicare ID - Type UnspecifiedPROVIDER NUMBER
FL15419Medicare UPIN