Healthcare Provider Details

I. General information

NPI: 1083036396
Provider Name (Legal Business Name): BEACH MEDICAL ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 ALTON ROAD SUITE 860
MIAMI BEACH FL
33140
US

IV. Provider business mailing address

4308 ALTON ROAD SUITE 860
MIAMI BEACH FL
33140
US

V. Phone/Fax

Practice location:
  • Phone: 305-604-2888
  • Fax: 305-604-2887
Mailing address:
  • Phone: 305-604-2888
  • Fax: 305-604-2887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS11420
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME84124
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME116150
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME112402
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME109832
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS115888
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME94949
License Number StateFL

VIII. Authorized Official

Name: GARY JOSEPH MERLINO
Title or Position: PRESIDENT
Credential: D.O.
Phone: 305-604-2888