Provider Demographics
NPI:1083948814
Name:BERINATO, BETH ANNE
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:BERINATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PALM BAY RD NE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8601
Mailing Address - Country:US
Mailing Address - Phone:321-725-8778
Mailing Address - Fax:
Practice Address - Street 1:145 PALM BAY RD NE
Practice Address - Street 2:SUITE 120
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8601
Practice Address - Country:US
Practice Address - Phone:321-725-8778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-27
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIA310ZOtherMEDICARE PTAN