Healthcare Provider Details

I. General information

NPI: 1588972749
Provider Name (Legal Business Name): NATHAN BELL P.A. -C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 SE SALERNO RD STE 110
STUART FL
34997-6572
US

IV. Provider business mailing address

2150 SE SALERNO RD STE 110
STUART FL
34997-6572
US

V. Phone/Fax

Practice location:
  • Phone: 772-781-2735
  • Fax: 772-781-2739
Mailing address:
  • Phone: 772-781-2735
  • Fax: 772-781-2739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085003850
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number10002389A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9119071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: