Individual
MARY B BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 ZINNIAS CT, HOMOSASSA, FL 34446-5628
(727) 560-8780
Mailing address
12 ZINNIAS CT, HOMOSASSA, FL 34446-5628
(727) 512-7596
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
1059541
FL
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
01/07/2019
Last updated
01/10/2019
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