Provider Demographics
NPI:1023489630
Name:BEE WELL PEDIATRICS
Entity type:Organization
Organization Name:BEE WELL PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-236-9860
Mailing Address - Street 1:PO BOX 880313
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34988-0313
Mailing Address - Country:US
Mailing Address - Phone:772-873-7114
Mailing Address - Fax:772-873-7115
Practice Address - Street 1:10521 SW VILLAGE CENTER DR
Practice Address - Street 2:101-A
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1930
Practice Address - Country:US
Practice Address - Phone:772-873-7114
Practice Address - Fax:772-873-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93497208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL281166900Medicaid