MEDICARE: DR. BRENT WILLIAM BELLOTTE M.D.

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
1	207W00000X	Ophthalmology Physician	ME92938	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
14	P00297975	OTHER	FL	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7281683	OTHER	FL	AETNA
2	0108909	OTHER	FL	GHI
3	201817723A	OTHER	FL	HUMANA
4	300438	OTHER	FL	AV MED
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	63665	OTHER	FL	GREAT WEST
7	9396256	OTHER	FL	PHCS
8	ME92938	OTHER	FL	AMERI PLAN
9	P3656087	OTHER	FL	OXFORD
10	PCS1492	OTHER	FL	PARTNER CARE
11	11021	OTHER	FL	DIMENSION
12	294278	OTHER	FL	AMERI GROUP
13	6290625	OTHER	FL	CIGNA
15	16021	OTHER	FL	BLUE CROSS BLUE SHIELD
16	08-00553	OTHER	FL	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1942209283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENT WILLIAM BELLOTTE M.D.

Provider Business Mailing Address
First Line	:	9325 GLADES ROAD
Second Line	:	SUITE 201
City	:	BOCA
State	:	FL
Zip	:	33434
Country	:	US
Telephone Number	:	561-488-1001
Fax Number	:

Provider Business Practice Location Address
First Line	:	9325 GLADES RD
Second Line	:	SUITE 201
City	:	BOCA RATON
State	:	FL
Zip	:	33434-3907
Country	:	US
Telephone Number	:	561-488-1001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/24/2012

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