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Individual

JOSHUA A BEASLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3000 S MCCALL RD, ENGLEWOOD, FL 34224-8616
(941) 841-4200
(941) 841-4201
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9108823
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015462200
FL
01
Y0T0R
BCBS
FL
Enumeration date
08/06/2015
Last updated
08/04/2024
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