Provider Demographics
NPI:1467676205
Name:BECK, SYLVIA ANN (ITDS)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:ANN
Last Name:BECK
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 LA VITA WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-2028
Mailing Address - Country:US
Mailing Address - Phone:561-734-2517
Mailing Address - Fax:561-740-2867
Practice Address - Street 1:12120 LA VITA WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-2028
Practice Address - Country:US
Practice Address - Phone:561-734-2517
Practice Address - Fax:561-740-2867
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist