MEDICARE: BEATRIZ E AMENDOLA MD PA

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	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1407515380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEATRIZ E AMENDOLA MD PA

Provider Business Mailing Address
First Line	:	5995 SW 71ST ST # 1-A
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-3531
Country	:	US
Telephone Number	:	305-669-6833
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 W 21ST ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-2614
Country	:	US
Telephone Number	:	305-669-6833
Fax Number	:	305-666-4030

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	BEATRIZ ELENA AMENDOLA
Credential	:	MD
Telephone Number	:	305-669-6833

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	01/04/2022

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