Provider Demographics
NPI:1861763526
Name:DORVIL-BELLO, MONICA CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:CAROLINA
Last Name:DORVIL-BELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 NE 191ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3922
Mailing Address - Country:US
Mailing Address - Phone:347-575-5677
Mailing Address - Fax:
Practice Address - Street 1:201 NW 70TH AVE # C
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-249-3950
Practice Address - Fax:888-805-8627
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125061207R00000X
FLME123342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016368600Medicaid