Healthcare Provider Details

I. General information

NPI: 1972908994
Provider Name (Legal Business Name): JEFFREY T BEAMS, D.O., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10929 N 56TH ST
TEMPLE TERRACE FL
33617-3000
US

IV. Provider business mailing address

10929 N 56TH ST
TEMPLE TERRACE FL
33617-3000
US

V. Phone/Fax

Practice location:
  • Phone: 813-513-3095
  • Fax: 913-513-3097
Mailing address:
  • Phone: 813-513-3095
  • Fax: 913-513-3097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS7230
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFREY THOMAS BEAMS
Title or Position: OWNER
Credential: D.O.
Phone: 813-513-3095