Healthcare Provider Details

I. General information

NPI: 1689398653
Provider Name (Legal Business Name): ASHLEY MEGAN BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 SE MONTEREY COMMONS BLVD
STUART FL
34996-3329
US

IV. Provider business mailing address

2211 NW FEDERAL HWY APT 1230
STUART FL
34994-9391
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-9400
  • Fax:
Mailing address:
  • Phone: 813-679-8514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9375671
License Number StateFL
# 2
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: