| Organization Name: | BEACHTOWN HEALTH CARE PLLC |
| NPI Number: | 1124251491 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND IGLECIA (OWNER) |
| Mailing Address: | 3750 Chesterfield Ave Virginia Beach |
| State: | VA US |
| Postal Code: | 234552940 |
| Phone Number: | 7574607189 |
| Fax Number: | |
| NPI Enumeration Date: | 09/02/2009 |
| NPI Last Update Date: | 07/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101057390 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |