Individual
BETH LONGENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4300 ALTON RD, MIAMI, FL 33140-2800
(305) 674-2064
Mailing address
PO BOX 863481, ORLANDO, FL 32886-3481
(800) 514-1494
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS0009595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28600
BCBS
FL
01
—
P00289503
RR MCR
FL
Enumeration date
03/10/2006
Last updated
04/20/2008
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