Healthcare Provider Details

I. General information

NPI: 1982532552
Provider Name (Legal Business Name): BEVERLY BARRAGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEVERLY ANN FOLZMAN

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3888 HIGHWAY 90
PACE FL
32571-1014
US

IV. Provider business mailing address

3888 HIGHWAY 90
PACE FL
32571-1014
US

V. Phone/Fax

Practice location:
  • Phone: 850-614-8623
  • Fax:
Mailing address:
  • Phone: 850-614-8623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11046048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: