MEDICARE: BEIBEI OELRICH M.D. PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	57.020462	OH
2	208800000X	Urology Physician	133986	FL

General Provider Information

NPI Number	:	1144519018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEIBEI OELRICH M.D. PHD

Provider Business Mailing Address
First Line	:	320 RACETRACK RD NW STE 100C
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-1796
Country	:	US
Telephone Number	:	850-863-0883
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 LIVE OAK ST STE A
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7300
Country	:	US
Telephone Number	:	386-243-4856
Fax Number	:	386-231-6582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	01/12/2026

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