Belloc Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME88797 Issued in FL

Legal business name

BELLOC CARE LLC

Practice address

102 Park Place Blvd
Building D Suite# 1
Kissimmee, FL 34741-2358

Phone

(407) 847-5805

Fax

(407) 343-5804

NPI assigned

Jan 22, 2007

Last updated

Apr 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rene Cajuste, MD

Title

Ceo

Phone

(407) 847-5805

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1902950504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "address_2": "BUILDING D SUITE #1",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412358",
            "telephone_number": "407-847-5805",
            "fax_number": "407-343-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "address_2": "BUILDING D SUITE# 1",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412358",
            "telephone_number": "407-847-5805",
            "fax_number": "407-343-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLOC CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "CAJUSTE",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-847-5805",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME88797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268371700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.