Provider Demographics
NPI:1497286728
Name:BELOUSOV, ALEKSEI KIRILLOVICH (MD)
Entity type:Individual
Prefix:
First Name:ALEKSEI
Middle Name:KIRILLOVICH
Last Name:BELOUSOV
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8507 CYPRESS HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-8119
Mailing Address - Country:US
Mailing Address - Phone:407-710-5599
Mailing Address - Fax:
Practice Address - Street 1:7009 DR PHILLIPS BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7228
Practice Address - Country:US
Practice Address - Phone:407-710-5599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME155782207RC0200X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program