Provider Demographics
NPI:1356358923
Name:BEAUCHAMP, MARITZA (MS)
Entity type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 MARION OAKS GOLF WAY
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-3529
Mailing Address - Country:US
Mailing Address - Phone:352-347-3395
Mailing Address - Fax:352-347-3395
Practice Address - Street 1:5664 S.W. 60 AVE.
Practice Address - Street 2:THE CENTERS
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:352-351-6900
Practice Address - Fax:352-351-6991
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health