Individual
DR. KEVIN RICHARD BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 DAVIS BLVD, SUITE 504, TAMPA, FL 33606-3463
(813) 627-5931
Mailing address
113 S MELVILLE AVE APT 4, TAMPA, FL 33606-1861
(410) 804-7070
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
TRN11389
FL
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
MT185033
PA
Other
Enumeration date
05/10/2007
Last updated
01/22/2010
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