Provider Demographics
NPI: | 1952383390 |
---|---|
Name: | BELTRAN, MARIA R (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | MARIA |
Middle Name: | R |
Last Name: | BELTRAN |
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: | 11995 SINGLETREE LN |
Mailing Address - Street 2: | STE 500 |
Mailing Address - City: | EDEN PRAIRIE |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55344-5347 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 952-595-1301 |
Mailing Address - Fax: | 612-294-4903 |
Practice Address - Street 1: | 1343 NW COCONUT POINT LN |
Practice Address - Street 2: | |
Practice Address - City: | STUART |
Practice Address - State: | FL |
Practice Address - Zip Code: | 34994-9485 |
Practice Address - Country: | US |
Practice Address - Phone: | 952-595-1100 |
Practice Address - Fax: | 612-294-4903 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-11-18 |
Last Update Date: | 2015-06-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 35 088574 | 2085R0202X, 2085U0001X, 2085H0002X, 2085N0700X, 2085N0904X, 2085P0229X, 2085R0001X, 2085R0203X, 2085R0204X, 207U00000X, 207UN0903X, 207UN0902X, 207UN0901X, 2085R0202X |
FL | ME77116 | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No | 2085H0002X | Allopathic & Osteopathic Physicians | Radiology | Hospice and Palliative Medicine |
No | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology |
No | 2085P0229X | Allopathic & Osteopathic Physicians | Radiology | Pediatric Radiology |
No | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No | 2085R0203X | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology |
No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | |
No | 207UN0903X | Allopathic & Osteopathic Physicians | Nuclear Medicine | In Vivo & In Vitro Nuclear Medicine |
No | 207UN0902X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Imaging & Therapy |
No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 000000536224 | Other | ANTHEM |
OH | 742144 | Other | BUCKEYE |
OH | P00412422 | Other | RAILROAD MEDICARE |
OH | 2691798 | Medicaid | |
OH | BE4196193 | Medicare PIN | |
OH | 000000221187 | Other | UNISON |
OH | 0604914 | Other | BCMH |
OH | 363351 | Other | WELLCARE |
OH | 5187673 | Other | AETNA |
FL | G45772 | Medicare UPIN | |
FL | G45772 | Medicare UPIN |