Healthcare Provider Details

I. General information

NPI: 1942374715
Provider Name (Legal Business Name): ROBERTO ARTURO BELTRAN FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AMESBURY ST 204
LAWRENCE MA
01840-1323
US

IV. Provider business mailing address

101 AMESBURY ST 204
LAWRENCE MA
01840-1323
US

V. Phone/Fax

Practice location:
  • Phone: 978-688-1919
  • Fax: 978-688-1923
Mailing address:
  • Phone: 978-688-1919
  • Fax: 978-688-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number264862
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: