MEDICARE: TERRI BECK PA-C

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	207N00000X	Dermatology Physician	PA9102849	FL

General Provider Information

NPI Number	:	1114916301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI BECK PA-C

Provider Business Mailing Address
First Line	:	17222 HOSPITAL BLVD STE 346
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34601-8925
Country	:	US
Telephone Number	:	352-796-3334
Fax Number	:	352-796-3323

Provider Business Practice Location Address
First Line	:	17222 HOSPITAL BLVD STE 346
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34601-8925
Country	:	US
Telephone Number	:	352-796-3334
Fax Number	:	352-796-3323

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	12/17/2025

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Directions to “ TERRI BECK PA-C” Practice Location

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