Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME68725 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME68725 | FL |
NPI | 1952399008 |
---|---|
Provider Name | Scott Warren Beck |
First Address | St Petersburg, FL 33701-4629 |
Second Address | St Petersburg, FL 33701-4629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 19/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
378295600 | (05) | FL |
F76822 | (02) | FL |