Provider Demographics
NPI:1174537690
Name:BELL, TROY (OD)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3754 HIGHWAY 90
Mailing Address - Street 2:SUITE 390
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1096
Mailing Address - Country:US
Mailing Address - Phone:850-266-7500
Mailing Address - Fax:850-290-5952
Practice Address - Street 1:3754 HIGHWAY 90
Practice Address - Street 2:SUITE 390
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1096
Practice Address - Country:US
Practice Address - Phone:850-266-7500
Practice Address - Fax:850-290-5952
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001531152W00000X
FLOPC 4113152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1116259OtherAETNA HMO
VA196146OtherANTHEM BCBS / FALLSCHURCH
VA196153OtherANTHEM BCBS / RESTON
VA7574740OtherAETNA PPO
V07459Medicare UPIN
018490N11Medicare ID - Type Unspecified