Provider Demographics
NPI:1912580036
Name:BIDO BELLO, JAIME ENRIQUE (MD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:ENRIQUE
Last Name:BIDO BELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 E TUFTS AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2579
Mailing Address - Country:US
Mailing Address - Phone:866-782-8393
Mailing Address - Fax:970-625-3706
Practice Address - Street 1:1400 PELHAM PKWY S, BRONX, NY 10461
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5000
Practice Address - Fax:970-625-3706
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2024-10-24
Deactivation Date:2022-04-28
Deactivation Code:
Reactivation Date:2023-10-03
Provider Licenses
StateLicense IDTaxonomies
CODR.0073848208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program