MEDICARE: JESSICA BEACHKOFSKY MD

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	2084P0800X	Psychiatry Physician	01067522A	IN
2	2084P0800X	Psychiatry Physician	R1172	TX
3	2084P0800X	Psychiatry Physician	ME133554	FL

General Provider Information

NPI Number	:	1073788659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BEACHKOFSKY MD

Provider Business Mailing Address
First Line	:	3618 SWANS LANDING DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4439
Country	:	US
Telephone Number	:	813-279-8878
Fax Number	:	813-336-8491

Provider Business Practice Location Address
First Line	:	3618 SWANS LANDING DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4439
Country	:	US
Telephone Number	:	727-542-4552
Fax Number	:

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

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	01/30/2026

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