Individual
MARY ELLEN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13020 N TELECOM PARKWAY, TEMPLE TERRACE, FL 33637
(813) 978-9700
(813) 558-6124
Mailing address
13020 N TELECOM PARKWAY, TEMPLE TERRACE, FL 33637
(813) 978-9700
(813) 558-6124
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
ME39434
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042695400
—
FL
01
—
1732948
CIGNA
FL
01
—
209671
AVMED
FL
01
—
240001743
MEDICARE RAILROAD
FL
01
—
30884
BC/BS
FL
01
—
4240438
AETNA
FL
Enumeration date
06/16/2005
Last updated
05/14/2018
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