Provider Demographics
NPI:1831380732
Name:STANLEY, BEENA M (MD)
Entity type:Individual
Prefix:
First Name:BEENA
Middle Name:M
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451-1255
Mailing Address - Country:US
Mailing Address - Phone:352-860-0202
Mailing Address - Fax:352-860-1918
Practice Address - Street 1:2671 W NORVELL BRYANT HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9440
Practice Address - Country:US
Practice Address - Phone:352-513-5906
Practice Address - Fax:352-513-4872
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME738912084N0400X, 207R00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL42332Medicare PIN
FLF68559Medicare UPIN