Healthcare Provider Details

I. General information

NPI: 1386264448
Provider Name (Legal Business Name): JEREMY BROOKS BECTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2020
Last Update Date: 08/05/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 SW 62ND AVE
MIAMI FL
33155-3009
US

IV. Provider business mailing address

2800 SW 27TH TER APT 401
MIAMI FL
33133-3069
US

V. Phone/Fax

Practice location:
  • Phone: 800-432-6837
  • Fax:
Mailing address:
  • Phone: 601-520-4804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: