Provider Demographics
NPI:1780420828
Name:BECKFORD, JULIAN
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2593 PINWHERRY ST NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-6845
Mailing Address - Country:US
Mailing Address - Phone:908-296-0244
Mailing Address - Fax:
Practice Address - Street 1:2593 PINWHERRY ST NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-6845
Practice Address - Country:US
Practice Address - Phone:908-296-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.538203163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse