=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861272296
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEYOND HEALTH MD, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2023
-----------------------------------------------------
Last Update Date | 10/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10344 W FLAGLER ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33174-1746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-546-0705
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10344 W FLAGLER ST
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33174-1746
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-546-0705
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. LILLIAM GUIMARAIS
-----------------------------------------------------
Credential | ARNP
-----------------------------------------------------
Telephone | 786-546-0705
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------