Provider Demographics
NPI:1003029596
Name:BEAVER & KIRSHNER, PA
Entity Type:Organization
Organization Name:BEAVER & KIRSHNER, PA
Other - Org Name:INFINITY MEDICAL & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-687-2020
Mailing Address - Street 1:1937 N MILITARY TRAIL
Mailing Address - Street 2:SUITE D
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:561-687-2020
Mailing Address - Fax:
Practice Address - Street 1:1937 N MILITARY TRL
Practice Address - Street 2:SUITE D
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4762
Practice Address - Country:US
Practice Address - Phone:561-687-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007144111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55497Medicare UPIN