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General NPI Number Information
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NPI Number | 1164532552
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Entity Type | Individual
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Provider Name | ALICE BEARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1639 ATLANTIC BLVD STE 100
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City | JACKSONVILLE
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State | FL
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Zip | 32207-3346
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Country | US
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Telephone | 866-400-3376
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Fax | 904-354-0673
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Provider Business Mailing Address
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Address Line | 151 SOUTHHALL LN STE 300
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City | MAITLAND
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State | FL
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Zip | 32751-7172
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Country | US
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Telephone | 866-400-3376
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Fax | 407-650-3455
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9102083
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License Number State | FL
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