Organization
SCOTT BEALS DO PA
Active
Other names
Dermatology Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT L. BEALS D.O. (PHYSICIAN)
(850) 897-7546
Entity
Organization
Contact information
Practice address
4566 E HIGHWAY 20, SUITE 101, NICEVILLE, FL 32578-8838
(850) 897-7546
(850) 897-7547
Mailing address
4566 E HIGHWAY 20, SUITE 101, NICEVILLE, FL 32578-8838
(850) 897-7546
(850) 897-7547
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
OS7143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13586Y
FLORIDA MEDICARE PTAN INDIVIDUAL #
FL
05
—
266706100
—
FL
01
—
K4270
FLORIDA MEDICARE PTAN GROUP #
FL
Enumeration date
05/10/2007
Last updated
11/24/2014
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