=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093722985
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRIDGET ANN BELLINGAR D.O.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/02/2006
-----------------------------------------------------
Last Update Date | 01/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7101 PARK ST. N.
-----------------------------------------------------
City | SEMINOLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-397-1559
-----------------------------------------------------
Fax | 727-391-0838
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7101 PARK ST. N.
-----------------------------------------------------
City | SEMINOLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-397-1559
-----------------------------------------------------
Fax | 727-391-0838
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | FLOS0005244
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------