Provider Demographics
NPI:1952796104
Name:BELLAMY, TAMMY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:BELLAMY
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:PO BOX 290351
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33687-0351
Mailing Address - Country:US
Mailing Address - Phone:813-463-6949
Mailing Address - Fax:813-540-8048
Practice Address - Street 1:4107 OAK KNOLL CT
Practice Address - Street 2:APT 71
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-2420
Practice Address - Country:US
Practice Address - Phone:813-233-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-04
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL465660376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker