MEDICARE: DR. OMAR E BEIDAS MD

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	208200000X	Plastic Surgery Physician	28491	OK
2	208200000X	Plastic Surgery Physician	ME137256	FL
3	2086S0122X	Plastic and Reconstructive Surgery Physician	ME137256	FL

General Provider Information

NPI Number	:	1184919102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OMAR E BEIDAS MD

Provider Business Mailing Address
First Line	:	265 E ROLLINS ST STE 5300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5519
Country	:	US
Telephone Number	:	407-821-3555
Fax Number	:	407-821-3556

Provider Business Practice Location Address
First Line	:	265 E ROLLINS ST STE 5300
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5519
Country	:	US
Telephone Number	:	407-821-3555
Fax Number	:	407-821-3556

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

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	03/03/2023

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