Organization
SCOTT BEALS DO PA
Active
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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