MEDICARE: DR. JONATHAN A. BEATTY M.D.

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	MD441308	PA
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	MD441308	PA
3	2084P0800X	Psychiatry Physician	ME162732	FL

General Provider Information

NPI Number	:	1205028149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN A. BEATTY M.D.

Provider Business Mailing Address
First Line	:	777 37TH ST STE C103
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-7301
Country	:	US
Telephone Number	:	772-300-9077
Fax Number	:	215-764-6447

Provider Business Practice Location Address
First Line	:	777 37TH ST STE C103
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-7301
Country	:	US
Telephone Number	:	772-300-9077
Fax Number	:	215-764-6447

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	06/02/2026

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