Provider Demographics
NPI:1972908994
Name:JEFFREY T BEAMS, D.O., P.A.
Entity Type:Organization
Organization Name:JEFFREY T BEAMS, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BEAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-513-3095
Mailing Address - Street 1:10929 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3000
Mailing Address - Country:US
Mailing Address - Phone:813-513-3095
Mailing Address - Fax:913-513-3097
Practice Address - Street 1:10929 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3000
Practice Address - Country:US
Practice Address - Phone:813-513-3095
Practice Address - Fax:913-513-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS72302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255455100Medicaid
FLF60612Medicare UPIN
FL57363AMedicare PIN