Provider Demographics
NPI:1023334745
Name:BELEAN, MARIA MAGDALENA (PA-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MAGDALENA
Last Name:BELEAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N 35TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5424
Mailing Address - Country:US
Mailing Address - Phone:954-961-7500
Mailing Address - Fax:954-964-8965
Practice Address - Street 1:4030 SHERIDAN ST STE C
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3564
Practice Address - Country:US
Practice Address - Phone:954-961-7500
Practice Address - Fax:954-964-8965
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105352363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL356791OtherAVMED
FL006528500Medicaid
FL0009661888OtherAETNA
FL0767692OtherCIGNA
FLP01027163OtherRAILROAD MCR
FLY0C8HOtherBCBS FL
FL1220753OtherWELLCARE