Healthcare Provider Details

I. General information

NPI: 1609213156
Provider Name (Legal Business Name): ANDREW JAMES BEECH D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9380 SW 150TH ST
MIAMI FL
33176-7947
US

IV. Provider business mailing address

9380 SW 150TH ST
MIAMI FL
33176-7947
US

V. Phone/Fax

Practice location:
  • Phone: 305-256-5270
  • Fax:
Mailing address:
  • Phone: 305-256-5270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberME171087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: