Provider Demographics
NPI:1003249566
Name:BEELITZ, JOHN DARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DARREN
Last Name:BEELITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7108 EDISON PL
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6057
Mailing Address - Country:US
Mailing Address - Phone:772-267-9276
Mailing Address - Fax:
Practice Address - Street 1:3222 COMMERCE PL STE A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1904
Practice Address - Country:US
Practice Address - Phone:772-267-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09355100207LP2900X
FLME119078207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX243ZMedicare UPIN