1497737795 NPI number — DR. ROBERT K BEAMER DO

Table of content: DR. ROBERT K BEAMER DO (NPI 1497737795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497737795 NPI number — DR. ROBERT K BEAMER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEAMER
Provider First Name:
ROBERT
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497737795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8250 BRYAN DAIRY RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LARGO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33777-1353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-545-4444
Provider Business Mailing Address Fax Number:
727-545-5855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8250 BRYAN DAIRY RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33777-1353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-545-4444
Provider Business Practice Location Address Fax Number:
727-545-5855
Provider Enumeration Date:
11/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS0003471 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 058442800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: AL403 . This is a "MEDICAID GROUP NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4544358 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7787970 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 82094 . This is a "BCBS INDIVIDUAL NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 82094W . This is a "MEDICARE INDIVIDUAL NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 72062C . This is a "BCBS GROUP #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 82094 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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