Provider Demographics
NPI:1134446586
Name:BEAUMONT, AMY L (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:L
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5665 PONCE DE LEON BLVD
Mailing Address - Street 2:ROOM 246
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2510
Mailing Address - Country:US
Mailing Address - Phone:305-284-1310
Mailing Address - Fax:305-284-6555
Practice Address - Street 1:5665 PONCE DE LEON BLVD
Practice Address - Street 2:ROOM 246
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2510
Practice Address - Country:US
Practice Address - Phone:305-284-1310
Practice Address - Fax:305-284-6555
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7953103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist