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General NPI Number Information
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NPI Number | 1215408208
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Entity Type | Organization
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Legal Business Name | SEI BELLO, LLC
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 01/24/2019
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Provider Practice Location Address
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Address Line | 4850 SUGARLOAF PKWY STE 501
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-2864
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Country | US
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Telephone | 678-519-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 MARKETPLACE BLVD # 130 420
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City | EAST POINT
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State | GA
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Zip | 30344-5747
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Country | US
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Telephone | 678-519-0334
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANISHUA ROBERTS
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Credential |
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Telephone | 678-519-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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