MEDICARE: BELLECUTIS LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1962351999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLECUTIS LLC

Provider Business Mailing Address
First Line	:	4465 US HIGHWAY 17 STE 120
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4800
Country	:	US
Telephone Number	:	989-529-2078
Fax Number	:	855-391-1555

Provider Business Practice Location Address
First Line	:	4465 US HIGHWAY 17 STE 120
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4800
Country	:	US
Telephone Number	:	989-529-2078
Fax Number	:	855-391-1555

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	CANDICE NEGRETE
Credential	:	FNP
Telephone Number	:	989-529-2078

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

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Directions to “BELLECUTIS LLC ” Practice Location

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