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General NPI Number Information
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NPI Number | 1306933353
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Entity Type | Individual
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Provider Name | SVETLANA ANA BEASLEY A.P.
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Gender | Female
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 1059 CHENEY HWY
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City | TITUSVILLE
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State | FL
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Zip | 32780
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Country | US
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Telephone | 321-720-8931
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Fax | 321-268-3939
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Provider Business Mailing Address
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Address Line | 4645 ZOLTAN DR.
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City | TITUSVILLE
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State | FL
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Zip | 32780
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Country | US
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Telephone | 321-720-8931
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Fax | 321-268-3939
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 2127
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License Number State | FL
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