Healthcare Provider Details

I. General information

NPI: 1285678763
Provider Name (Legal Business Name): DOUGLAS M. BEEK D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 SW 22ND ST
CORAL GABLES FL
33145-3409
US

IV. Provider business mailing address

2441 SW 22ND ST
CORAL GABLES FL
33145-3409
US

V. Phone/Fax

Practice location:
  • Phone: 305-856-6441
  • Fax: 305-854-3880
Mailing address:
  • Phone: 305-856-6441
  • Fax: 305-854-3880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO1559
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: