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General NPI Number Information
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NPI Number | 1003068214
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Entity Type | Individual
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Provider Name | MR. LEANDER JOSTIN BEAMS SR.
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Gender | Male
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 45 MCLEOD ST
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3523
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Country | US
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Telephone | 321-452-2016
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 LANDINGS CIR APT 304
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City | ORLANDO
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State | FL
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Zip | 32824-0018
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Country | US
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Telephone | 619-251-7696
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11035096
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License Number State | FL
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