Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO1513 | FL |
N | 213ES0103X | Foot & Ankle Surgery | PO1513 | FL |
N | 213ES0131X | Foot Surgery | PO1513 | FL |
NPI | 1568432722 |
---|---|
Provider Name | Beth S Pearce |
First Address | St Augustine, FL 32086-4202 |
Second Address | St Augustine, FL 32086-4202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 27/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174540001 | DMERC (01) | FL |
1174540001 | DMERC CIGNA GOVT SVCS (01) | FL |
T85786 | (02) | FL |