Provider Demographics
NPI:1366468977
Name:BEECHAM, ROBERT PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PAUL
Last Name:BEECHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:PAUL
Other - Last Name:BEECHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:131 E SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-7011
Mailing Address - Country:US
Mailing Address - Phone:305-987-3206
Mailing Address - Fax:866-263-6086
Practice Address - Street 1:131 E SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-7011
Practice Address - Country:US
Practice Address - Phone:305-987-3206
Practice Address - Fax:866-263-6086
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME690402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31809OtherBCBS
FL31809Medicare ID - Type Unspecified