Healthcare Provider Details

I. General information

NPI: 1023970787
Provider Name (Legal Business Name): BELLA ROS MEDICAL AESTHETICS & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 SE FEDERAL HWY STE 600
STUART FL
34994-4531
US

IV. Provider business mailing address

2440 SE FEDERAL HWY STE 600
STUART FL
34994-4531
US

V. Phone/Fax

Practice location:
  • Phone: 941-205-9787
  • Fax:
Mailing address:
  • Phone: 941-205-9787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ROSE TIPPETT
Title or Position: OWNER, NP
Credential: CRNP, FNP-C, CANS
Phone: 941-205-9787