Healthcare Provider Details

I. General information

NPI: 1699764993
Provider Name (Legal Business Name): KENNETH BEER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 04/29/2024
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N DIXIE HWY SUITE 305
WEST PALM BEACH FL
33401-2712
US

IV. Provider business mailing address

1500 N DIXIE HWY SUITE 305
WEST PALM BEACH FL
33401-2712
US

V. Phone/Fax

Practice location:
  • Phone: 561-600-4848
  • Fax: 561-655-9233
Mailing address:
  • Phone: 561-655-9055
  • Fax: 561-655-9233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME59480
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberME59480
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberME59480
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME59480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: