Individual
KERIEA TIA BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2395 S WASHINGTON AVE STE 1, TITUSVILLE, FL 32780-4702
(321) 385-7979
(321) 385-7978
Mailing address
900 VILLAGE SQUARE XING STE 290, PALM BEACH GARDENS, FL 33410-4552
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
APRN11019420
FL
363L00000X
Nurse Practitioner
Primary
APRN11019420
FL
Other
Enumeration date
04/27/2022
Last updated
08/19/2022
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