=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821493321
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEPHEN BELMORE JR. L.AC., DOM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2014
-----------------------------------------------------
Last Update Date | 10/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6251 44TH ST N STE 6
-----------------------------------------------------
City | PINELLAS PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33781-5900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-313-0625
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6085 51ST TER N
-----------------------------------------------------
City | KENNETH CITY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33709-3521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-313-0625
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AP 3324
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------