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General NPI Number Information
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NPI Number | 1811480114
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Entity Type | Individual
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Provider Name | ALYSSA M BEAUDET PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 09/02/2023
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Provider Practice Location Address
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Address Line | 8645 N MILITARY TRL STE 508
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6296
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Country | US
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Telephone | 772-403-2227
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Fax | 772-403-2230
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Provider Business Mailing Address
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Address Line | 650 SE INDIAN ST STE 4
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City | STUART
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State | FL
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Zip | 34997-5565
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Country | US
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Telephone | 772-403-2227
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9116363
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License Number State | FL
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