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General NPI Number Information
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NPI Number | 1154623155
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Entity Type | Organization
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Legal Business Name | MICHAEL E. BELOTTI, D.O., P.A.
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 10111 FOREST HILL BLVD SUITE 202
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City | WELLINGTON
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State | FL
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Zip | 33414-6108
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Country | US
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Telephone | 561-798-1995
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Fax | 561-798-4422
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Provider Business Mailing Address
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Address Line | 10111 FOREST HILL BLVD SUITE 202
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City | WELLINGTON
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State | FL
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Zip | 33414-6108
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Country | US
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Telephone | 561-798-1995
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Fax | 561-798-4422
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL E. BELOTTI JR.
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Credential | D.O.
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Telephone | 561-798-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS4654
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License Number State | FL
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