Provider Demographics
NPI:1255734976
Name:DREIKER, BETH (RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:DREIKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 W COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4325
Mailing Address - Country:US
Mailing Address - Phone:954-475-5500
Mailing Address - Fax:954-625-8770
Practice Address - Street 1:9800 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33351-4325
Practice Address - Country:US
Practice Address - Phone:954-475-5500
Practice Address - Fax:954-625-8770
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9162814163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice