MEDICARE: MR. JUSTIN BEARD

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	367500000X	Certified Registered Nurse Anesthetist	APRN11044542	FL

General Provider Information

NPI Number	:	1861357964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JUSTIN BEARD

Provider Business Mailing Address
First Line	:	3661 SHAWNEE SHORES DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-4302
Country	:	US
Telephone Number	:	904-294-3921
Fax Number	:

Provider Business Practice Location Address
First Line	:	3661 SHAWNEE SHORES DR
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-4302
Country	:	US
Telephone Number	:	904-294-3921
Fax Number	:

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

Provider Enumeration Date	:	12/19/2025
Last Update Date	:	01/05/2026

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Directions to “ MR. JUSTIN BEARD ” Practice Location

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