Provider Demographics
NPI:1174559264
Name:PERALTA, BELLA (PT)
Entity type:Individual
Prefix:MRS
First Name:BELLA
Middle Name:
Last Name:PERALTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 DEER PARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-7013
Mailing Address - Country:US
Mailing Address - Phone:727-376-4085
Mailing Address - Fax:727-376-4671
Practice Address - Street 1:5141 DEER PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-7013
Practice Address - Country:US
Practice Address - Phone:727-376-4085
Practice Address - Fax:727-376-4671
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist