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NPI Code Detail

MEDICARE: EUGENE R BEBEAU JR. M.D.

MEDICARE: EUGENE R BEBEAU JR. 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
1207L00000XAnesthesiology PhysicianME0059387FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386628642
Entity Type Code : Individual
Provider Name (Legal Business Name) : EUGENE R BEBEAU JR. M.D.
Provider Business Mailing Address
First Line : 851 TRAFALGAR COURT
Second Line : SUITE 200E
City : MAITLAND
State : FL
Zip : 32751
Country : US
Telephone Number : 407-667-0444
Fax Number : 407-667-4338
Provider Business Practice Location Address
First Line : 800 PRUDENTIAL DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8202
Country : US
Telephone Number : 904-398-3356
Fax Number : 904-398-5397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 07/20/2017

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