Healthcare Provider Details

I. General information

NPI: 1023334596
Provider Name (Legal Business Name): LARIVEN BELTRAN FRANADA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3591 GRIFFIN AVE
PEKIN IL
61554-6258
US

IV. Provider business mailing address

3591 GRIFFIN AVE
PEKIN IL
61554-6258
US

V. Phone/Fax

Practice location:
  • Phone: 309-353-6301
  • Fax:
Mailing address:
  • Phone: 309-353-6301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036132321
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036-132321
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: