Basic Information
| Provider Information | |||||||||
| NPI: | 1982797015 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 S. AUSTRAILIAN AVE. | ||||||||
| Address2: | STE 400 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618058500 | ||||||||
| FaxNumber: | 5618374855 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 WEST GRANADA BLVD | ||||||||
| Address2: | STE 4 | ||||||||
| City: | ORMOND BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32175 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3866769690 | ||||||||
| FaxNumber: | 3866765418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 08/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 15682 | NE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 04372 | 01 | NE | BCBS OF NE | OTHER | 12129 | 01 | NE | MIDLANDS CHOICE | OTHER |