Provider Demographics
NPI:1275628562
Name:BEERS, BETSY B (MD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:B
Last Name:BEERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 76 DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607
Mailing Address - Country:US
Mailing Address - Phone:352-332-4051
Mailing Address - Fax:352-332-2966
Practice Address - Street 1:350 NW 76 DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607
Practice Address - Country:US
Practice Address - Phone:352-332-4051
Practice Address - Fax:352-332-2966
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30399207N00000X, 207ZD0900X
FLME 0061199207N00000X, 207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatology
Not Answered207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68569OtherBLUE CROSS BLUE SHIELD
685694Medicare ID - Type Unspecified
FL68569OtherBLUE CROSS BLUE SHIELD