Healthcare Provider Details

I. General information

NPI: 1194336719
Provider Name (Legal Business Name): ASHLYN NICOLE BECK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 SW 20TH PL STE 100
OCALA FL
34471-7881
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 522-371-2123
  • Fax: 352-237-0066
Mailing address:
  • Phone: 205-731-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9115905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: