Provider Demographics
NPI:1699814384
Name:JEFFREY S BEITLER MD PA
Entity Type:Organization
Organization Name:JEFFREY S BEITLER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:BEITLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-494-3737
Mailing Address - Street 1:333 LAS OLAS WAY
Mailing Address - Street 2:SUITE 2504
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301
Mailing Address - Country:US
Mailing Address - Phone:954-494-3737
Mailing Address - Fax:800-952-7026
Practice Address - Street 1:333 LAS OLAS WAY
Practice Address - Street 2:SUITE 2504
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2363
Practice Address - Country:US
Practice Address - Phone:954-494-3737
Practice Address - Fax:800-952-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30512207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty