| Doctor Name: | SHEPHERD LEE BEASLEY |
| NPI Number: | 1518016492 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | C.PED |
| License Number: | PED129 |
| Business Practice Address: | 2311 Santa Barbara Blvd Suite 105 Cape Coral, FL - 339914394 |
| Business Phone Number: | 2394583360 |
| Business Fax Number: | 2392421095 |
| Mailing Address: | 2311 Santa Barbara Blvd, Suite 105 CAPE CORAL |
| State: | FL |
| Postal Code: | 339914394 |
| Phone Number: | 2394583360 |
| Fax Number: | 2392421095 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 09/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225000000X |
| License Number: | PED129 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotic Fitter |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the management of fitting prefabricated orthoses. |