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General NPI Number Information
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NPI Number | 1497059851
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Entity Type | Individual
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Provider Name | BETH T GROSSMAN MCKEE PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 5597 N DIXIE HWY
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3406
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Country | US
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Telephone | 954-229-7962
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Fax | 954-229-7913
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Provider Business Mailing Address
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Address Line | 365 LENNON LN STE 250
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City | WALNUT CREEK
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State | CA
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Zip | 94598-5915
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Country | US
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Telephone | 925-948-8143
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Fax | 925-948-8143
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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 | PA9106152
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License Number State | FL
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