Doctor Name: | DR. CASEY JUSTIN BEAL |
NPI Number: | 1003120262 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 1600 Sw Archer Rd Box 100284 Gainesville, FL - 326100284 |
Business Phone Number: | 3522738778 |
Business Fax Number: | |
Mailing Address: | Po Box 13833, PHILADELPHIA |
State: | PA |
Postal Code: | 191013833 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/29/2010 |
NPI Last Update Date: | 09/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |