Healthcare Provider Details

I. General information

NPI: 1750845038
Provider Name (Legal Business Name): APEX VIBRANCY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 INDIAN SCHOOL RD NE STE 101
ALBUQUERQUE NM
87106-2653
US

IV. Provider business mailing address

406 ORTIZ DR NE
ALBUQUERQUE NM
87108-1451
US

V. Phone/Fax

Practice location:
  • Phone: 505-255-8682
  • Fax: 505-255-7890
Mailing address:
  • Phone: 505-595-4183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DINA DENISE BELLO
Title or Position: DOCTOR OF ORIENTAL MEDICINE
Credential: DOM
Phone: 805-233-4998