Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0S3368 | FL |
NPI | 1164466108 |
---|---|
Provider Name | Michael Howard Beilan |
First Address | New Port Richey, FL 34653-6036 |
Second Address | New Port Richey, FL 34653-6036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E32087 | (02) | FL |