Provider Demographics
NPI:1528191152
Name:BEAMGUARD, JENNIFER E (MSPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:E
Last Name:BEAMGUARD
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPAS, PA-C
Mailing Address - Street 1:5210 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4518
Mailing Address - Country:US
Mailing Address - Phone:813-882-9986
Mailing Address - Fax:813-341-3259
Practice Address - Street 1:3950 3RD ST N STE A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-6123
Practice Address - Country:US
Practice Address - Phone:727-821-0612
Practice Address - Fax:727-822-5507
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101702363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008180700Medicaid
FLP70669Medicare UPIN