Provider Demographics
NPI:1972579506
Name:DICKINSON, BELINDA ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:ELAINE
Last Name:DICKINSON
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 1:1325 S APOLLO BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3146
Mailing Address - Country:US
Mailing Address - Phone:321-676-5623
Mailing Address - Fax:321-984-8951
Practice Address - Street 1:1325 S APOLLO BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3146
Practice Address - Country:US
Practice Address - Phone:321-676-5623
Practice Address - Fax:321-984-8951
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041832207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05477Medicare ID - Type Unspecified
FLD51312Medicare UPIN