Provider Demographics
NPI:1306627765
Name:DR BE DORAL
Entity type:Organization
Organization Name:DR BE DORAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS,FAARFM, HCMBA
Authorized Official - Phone:305-699-7399
Mailing Address - Street 1:2500 NW 107TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5923
Mailing Address - Country:US
Mailing Address - Phone:305-699-7399
Mailing Address - Fax:786-870-1733
Practice Address - Street 1:2500 NW 107TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-5923
Practice Address - Country:US
Practice Address - Phone:305-699-7399
Practice Address - Fax:786-870-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty