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NPI Code Detail

MEDICARE: AWILDA NELIDA BELLE PA-C

MEDICARE: AWILDA NELIDA BELLE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA0001619FL
2363AM0700XMedical Physician AssistantPA0001619FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164756490
Entity Type Code : Individual
Provider Name (Legal Business Name) : AWILDA NELIDA BELLE PA-C
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 3402 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6214
Country : US
Telephone Number : 813-875-3950
Fax Number : 813-287-2274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2009
Last Update Date : 03/24/2026

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Directions to “ AWILDA NELIDA BELLE PA-C” Practice Location

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