Provider Demographics
NPI:1366630717
Name:BEARD, MARGITA V (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGITA
Middle Name:V
Last Name:BEARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1416 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-4607
Mailing Address - Country:US
Mailing Address - Phone:941-794-3998
Mailing Address - Fax:941-792-2751
Practice Address - Street 1:1416 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-4607
Practice Address - Country:US
Practice Address - Phone:941-794-3998
Practice Address - Fax:941-792-2751
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067285208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31612Medicare PIN