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General NPI Number Information
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NPI Number | 1134539653
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Entity Type | Organization
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Legal Business Name | BEYOND GERIATRICS, LLC
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Dates
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Enumeration Date | 05/06/2014
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 1227 S MYRTLE AVE
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City | CLEARWATER
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State | FL
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Zip | 33756-3469
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Country | US
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Telephone | 727-939-6196
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Fax | 727-350-9396
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Provider Business Mailing Address
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Address Line | 1227 S MYRTLE AVE
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City | CLEARWATER
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State | FL
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Zip | 33756-3469
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Country | US
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Telephone | 727-939-6196
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Fax | 727-350-9396
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLEY D EVANS
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Credential | MD
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Telephone | 727-939-6196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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