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General NPI Number Information
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NPI Number | 1023005600
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Entity Type | Organization
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Legal Business Name | PSHS BETA PARTNERS LTD
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 401 S. LEJEUNE RD. SUITE 201
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City | MIAMI
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State | FL
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Zip | 33134-1938
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Country | US
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Telephone | 305-447-0882
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Fax | 305-447-0213
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Provider Business Mailing Address
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Address Line | 401 SW 42ND AVE STE 201
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City | MIAMI
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State | FL
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Zip | 33134
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Country | US
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Telephone | 305-447-0882
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Fax | 305-447-0213
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1090
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License Number State | FL
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