Provider Demographics
NPI:1639397540
Name:BEACH, RICK A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:A
Last Name:BEACH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1040 GULF BREEZE PKWY
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-7809
Mailing Address - Country:US
Mailing Address - Phone:850-473-9434
Mailing Address - Fax:850-916-8759
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:SUITE 208
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7809
Practice Address - Country:US
Practice Address - Phone:850-473-9434
Practice Address - Fax:850-916-8759
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-05-06
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Provider Licenses
StateLicense IDTaxonomies
FLME40826207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD50756Medicare UPIN