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NPI Code Detail

MEDICARE: DR. KAYANNA SUZANNE BECKMANN D.M.D

MEDICARE: DR. KAYANNA SUZANNE BECKMANN D.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
1122300000XDentistDN20604FL

General Provider Information

NPI Number : 1477965051
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAYANNA SUZANNE BECKMANN D.M.D
Provider Business Mailing Address
First Line : 4240 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33609-2231
Country : US
Telephone Number : 813-636-7400
Fax Number :
Provider Business Practice Location Address
First Line : 4240 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33609-2231
Country : US
Telephone Number : 813-636-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 05/29/2014

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