Jack M Bellafiore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102570 Issued in FL

Practice address

1117 N Olive Ave
Suite 202
West Palm Beach, FL 33401-3520

Phone

(561) 655-4450

Fax

(561) 655-4469

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1215991690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 N OLIVE AVE",
            "address_2": "SUITE 202",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013520",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 N OLIVE AVE",
            "address_2": "SUITE 202",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013520",
            "telephone_number": "561-655-4450",
            "fax_number": "561-655-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAFIORE",
        "first_name": "JACK",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291679700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael David Bell, M.D.
• Shanteria Tashaye Bell, LPN
• Shenelle Regina Bell
• Tamoya Bell, LMHC
• Timothy Charles Bell, MD
• Sai Vijaya Bellam, M.D.
• Fayola Bellange
• Megan Bellardini
• Andre Belle
• Bevelyn Bellevue

• Physician Assistant in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.