Provider Demographics
NPI:1982462602
Name:ALFONSO BELLO, JULIO CESAR SR
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:ALFONSO BELLO
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 QUARRY ROCK CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-4358
Mailing Address - Country:US
Mailing Address - Phone:407-781-6173
Mailing Address - Fax:
Practice Address - Street 1:338 QUARRY ROCK CIR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-4358
Practice Address - Country:US
Practice Address - Phone:407-781-6173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1057942106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician