Provider Demographics
NPI:1215216478
Name:CARY, BETH A (LMT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:CARY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 COLLEGE PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-5191
Mailing Address - Country:US
Mailing Address - Phone:239-489-2290
Mailing Address - Fax:239-482-6028
Practice Address - Street 1:8595 COLLEGE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-5191
Practice Address - Country:US
Practice Address - Phone:239-489-2290
Practice Address - Fax:239-482-6028
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA63996171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor