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General NPI Number Information
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NPI Number | 1184189169
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Entity Type | Organization
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Legal Business Name | BELA UROGYNECOLOGY LLC
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 1178 CYPRESS GLEN CIR STE 2
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City | KISSIMMEE
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State | FL
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Zip | 34741-7560
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Country | US
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Telephone | 407-982-4852
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402
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City | GOTHA
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State | FL
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Zip | 34734-0402
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Country | US
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Telephone | 407-982-4852
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. BELA KUDISH
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Credential | MD
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Telephone | 586-420-3955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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