Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 48098 | MN |
Y | 2084N0402X | Child Neurologist | ME105958 | FL |
N | 2084N0600X | Clinical Neurophysiologist | ME105958 | FL |
NPI | 1003888637 |
---|---|
Provider Name | Luis E Bello Espinosa |
First Address | Orlando, FL 32806-1051 |
Second Address | Orlando, FL 32806-1051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 20/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101743100 | (05) | FL |
F41361 | (02) |