Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME81992 | FL |
NPI | 1003892910 |
---|---|
Provider Name | Stephen Smyth Beebe |
First Address | Gainesville, FL 32605-4381 |
Second Address | Gainesville, FL 32605-4381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H51226 | (02) |