Provider Demographics
NPI:1497013163
Name:MARY BEESON, M.D. PA
Entity Type:Organization
Organization Name:MARY BEESON, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEESON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-503-7544
Mailing Address - Street 1:701 SEDDON COVE WAY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5702
Mailing Address - Country:US
Mailing Address - Phone:813-503-7544
Mailing Address - Fax:
Practice Address - Street 1:417 CORBETT ST
Practice Address - Street 2:
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-3305
Practice Address - Country:US
Practice Address - Phone:727-441-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty