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General NPI Number Information
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NPI Number | 1720388754
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Entity Type | Organization
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Legal Business Name | BEACH HEALTH CENTER LLC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 16517 VANDERBILT DR STE 3
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7550
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Country | US
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Telephone | 239-765-6000
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Fax | 239-765-6008
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Provider Business Mailing Address
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Address Line | 6051 ESTERO BLVD
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City | FORT MYERS BEACH
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State | FL
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Zip | 33931-4348
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Country | US
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Telephone | 239-765-6000
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Fax | 239-765-6008
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. ELIZABETH ULMAN
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Credential | PA-C
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Telephone | 239-765-6000
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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 | PA 9104861
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License Number State | FL
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