Provider Demographics
NPI:1164193777
Name:BEATO, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:BEATO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18341 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6027
Mailing Address - Country:US
Mailing Address - Phone:786-286-7665
Mailing Address - Fax:
Practice Address - Street 1:18341 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6027
Practice Address - Country:US
Practice Address - Phone:786-286-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities