Provider Demographics
NPI:1699882290
Name:BELSARE, DEVYANI (MD)
Entity type:Individual
Prefix:DR
First Name:DEVYANI
Middle Name:
Last Name:BELSARE
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 1:761 CIARA CREEK CV
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4659
Mailing Address - Country:US
Mailing Address - Phone:407-557-2165
Mailing Address - Fax:407-550-6409
Practice Address - Street 1:761 CIARA CREEK CV
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4659
Practice Address - Country:US
Practice Address - Phone:407-557-2165
Practice Address - Fax:407-550-6409
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100607208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000602500Medicaid