Provider Demographics
NPI:1568652758
Name:BECKER, CAREN BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREN
Middle Name:BETH
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17201 COLLINS AVE
Mailing Address - Street 2:#1702
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3475
Mailing Address - Country:US
Mailing Address - Phone:214-868-6300
Mailing Address - Fax:305-307-7201
Practice Address - Street 1:17201 COLLINS AVE
Practice Address - Street 2:#1702
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3475
Practice Address - Country:US
Practice Address - Phone:214-868-6300
Practice Address - Fax:305-307-7201
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013034092207P00000X
IN01073003A207P00000X
FLME113943207P00000X
LAMD.203184207P00000X
WV25854207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1000566Medicaid