MEDICARE: PETER BEICHMAN ADMINISTRATOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	299991436	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033414610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER BEICHMAN ADMINISTRATOR

Provider Business Mailing Address
First Line	:	1210 S FEDERAL HWY
Second Line	:	SUITE 101
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6044
Country	:	US
Telephone Number	:	561-752-9888
Fax Number	:	561-752-9899

Provider Business Practice Location Address
First Line	:	1210 S FEDERAL HWY
Second Line	:	SUITE 101
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6044
Country	:	US
Telephone Number	:	561-752-9888
Fax Number	:	561-752-9899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	01/13/2011

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