Provider Demographics
NPI:1740341700
Name:ANARUMO, BEVERLY J (DO)
Entity type:Individual
Prefix:MISS
First Name:BEVERLY
Middle Name:J
Last Name:ANARUMO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:B
Other - Middle Name:J
Other - Last Name:ANARUMO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO, PA
Mailing Address - Street 1:1655 TAMIAMI TRL
Mailing Address - Street 2:BLDG 6
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1042
Mailing Address - Country:US
Mailing Address - Phone:941-629-3618
Mailing Address - Fax:941-629-9809
Practice Address - Street 1:1655 TAMIAMI TRL
Practice Address - Street 2:BLDG 6
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1042
Practice Address - Country:US
Practice Address - Phone:941-629-3618
Practice Address - Fax:941-629-9809
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5876208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL316596OtherSTAYWELL (WELLCARE) PC
FL316750OtherSTAYWELL (WELLCARE) NP
FL650932281OtherHUMANA
FL650932281OtherUNITED HEALTHCARE
FL650932281OtherBEECH STREET
FL4244457OtherAETNA
FL650932281OtherCIGNA
FL650932281OtherEVOLUTIONS
FL372578201Medicaid
FL80697OtherBLUE CROSS BLUE SHIELD
FL650932281OtherHUMANA MILITARY
FL372578200Medicaid
FL650932281OtherPRIVATE HEALTHCARE SYSTEM
FL650932281OtherHUMANA MILITARY