Physician Compare National (NPI:1063521201)

HEALTHCARE PROVIDER: NICOLE L BEEDLE O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1063521201
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5597814020
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090512000631
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEEDLE
	Individual professional last name
Provider First Name	NICOLE
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	519 N MILLS AVE
	Group Practice or individual's line 1 address
City	ORLANDO
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	328035313
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y