Healthcare Provider Details

I. General information

NPI: 1821456948
Provider Name (Legal Business Name): LOLIEHT ACOSTA BELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22790 SW 112TH AVE
MIAMI FL
33170-7602
US

IV. Provider business mailing address

1990 W 56TH ST APT 1121
HIALEAH FL
33012-6905
US

V. Phone/Fax

Practice location:
  • Phone: 305-235-2616
  • Fax: 305-235-6178
Mailing address:
  • Phone: 305-494-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: