Healthcare Provider Details

I. General information

NPI: 1326330259
Provider Name (Legal Business Name): DBEIRA NP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 SW 75TH AVE
MIAMI FL
33155-2805
US

IV. Provider business mailing address

14604 SW 80TH ST
MIAMI FL
33183-2918
US

V. Phone/Fax

Practice location:
  • Phone: 305-264-5252
  • Fax:
Mailing address:
  • Phone: 305-388-3486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9264489
License Number StateFL

VIII. Authorized Official

Name: DAVID BEIRA
Title or Position: PRESIDENT
Credential: ARNP
Phone: 786-338-1955