Organization
HENDRY COUNTY HOSPITAL AUTHORITY
Active
Other names
Hendry Regional Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LYNN W. BEASLEY (CEO)
(863) 902-3076
Entity
Organization
Contact information
Practice address
524 W SAGAMORE AVE, CLEWISTON, FL 33440-3514
(863) 902-3022
(863) 983-3426
Mailing address
524 W SAGAMORE AVE, CLEWISTON, FL 33440-3514
(863) 902-3022
(863) 983-3426
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3995
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0098
MEDICARE PART B
FL
Enumeration date
07/19/2006
Last updated
10/18/2012
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