Healthcare Provider Details

I. General information

NPI: 1770289167
Provider Name (Legal Business Name): JAMES A BEIGHLEY APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100108
GAINESVILLE FL
32610-0108
US

V. Phone/Fax

Practice location:
  • Phone: 904-305-2001
  • Fax:
Mailing address:
  • Phone: 352-273-5670
  • Fax: 352-273-5683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN11024377
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: