MEDICARE: ALICIA BEEBE NP

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	363LA2200X	Adult Health Nurse Practitioner	9403992	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9403992	FL
3	363LA2200X	Adult Health Nurse Practitioner	002966	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184696890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA BEEBE NP

Provider Business Mailing Address
First Line	:	13045 MJ RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-1278
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13045 MJ RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-1278
Country	:	US
Telephone Number	:	860-995-0458
Fax Number	:

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	11/25/2019

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Directions to “ ALICIA BEEBE NP” Practice Location

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