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NPI Code Detail

MEDICARE: MS. CARMELLE BEAUVAIS PA-C

MEDICARE: MS. CARMELLE BEAUVAIS PA-C
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
1363A00000XPhysician Assistant5601011153MI
2363A00000XPhysician AssistantPA9102688FL
3363A00000XPhysician Assistant10004061AIN
4363A00000XPhysician Assistant026644NY
5363A00000XPhysician Assistant085009418IL
6363A00000XPhysician Assistant59596CA
7363A00000XPhysician Assistant10509GA

Other Identifiers

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

General Provider Information

NPI Number : 1750387254
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARMELLE BEAUVAIS PA-C
Provider Business Mailing Address
First Line : 9100 S DADELAND BLVD STE 1500
Second Line :
City : MIAMI
State : FL
Zip : 33156-7816
Country : US
Telephone Number : 415-424-4266
Fax Number : 415-520-6633
Provider Business Practice Location Address
First Line : 10775 PIONEER TRL STE 215
Second Line :
City : TRUCKEE
State : CA
Zip : 96161-0234
Country : US
Telephone Number : 415-424-4266
Fax Number : 415-520-6633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 03/13/2024

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1033106802 — DR. LINDARA L HALLORAN MD
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1144268863 — DR. ADRIAN J KHAW MD
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96161-0234
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1104838614 — DR. MARIA SYLMA ORTIZ-TWEED M.D.
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1750429155 — KARLA MARINA COMBS MPAS, PA-C
Practice Location Address:
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Practice Fax: 415-520-6633

Directions to “ MS. CARMELLE BEAUVAIS PA-C” Practice Location

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