Provider Demographics
NPI:1083036396
Name:BEACH MEDICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:BEACH MEDICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MERLINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-604-2888
Mailing Address - Street 1:4308 ALTON ROAD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-604-2888
Mailing Address - Fax:305-604-2887
Practice Address - Street 1:4308 ALTON ROAD
Practice Address - Street 2:SUITE 860
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-604-2888
Practice Address - Fax:305-604-2887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94949208M00000X
FLOS11420208M00000X
FLME84124208M00000X
FLME116150208M00000X
FLME112402208M00000X
FLME109832208M00000X
FLOS115888208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1326103532Medicaid
FLGZ580ZMedicare PIN
FLE8007YMedicare PIN
FLHO017ZMedicare PIN
FLGL818ZMedicare PIN
FLGJ016ZMedicare PIN
FLGJ563ZMedicare PIN
FLAE869ZMedicare PIN