Provider Demographics
NPI:1932349131
Name:BELLO GONZALEZ, PEDRO J (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:J
Last Name:BELLO GONZALEZ
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:PMB 135 P.O. BOX 8901
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8901
Mailing Address - Country:US
Mailing Address - Phone:787-898-1042
Mailing Address - Fax:
Practice Address - Street 1:BARRIO CORCOVADA. CARRETERA 130. R. 492.
Practice Address - Street 2:KILOMETER 2. HECTOMETER 3 INTERIOR.
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-898-1042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17445208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice