Maria Judith Storer Beauchamp, CST

Individual provider Active NPI Surgical Technologist · Altamonte SPG, FL

NPI 1104356526 · NPPES record last updated Jun 18, 2017

Key facts

NPI
1104356526
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Technologist 246ZS0410X
License
143194 (FL)
Practice address
714 Jamestown Blvd Apt 2271
Altamonte SPG, FL 32714-4691
Phone
(954) 851-5417
Fax
(954) 851-5417
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
143194FLMDSurgical Technologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Technologist 246ZS0410X 143194 FL Yes

Addresses

Primary practice location

714 Jamestown Blvd Apt 2271
Altamonte SPG, FL 32714-4691

Mailing address

714 Jamestown Blvd Apt 2271
Altamonte Springs, FL 32714-4691
Phone (954) 851-5417

Other providers in Altamonte SPG, FL

All providers in Altamonte SPG, FL · Surgical Technologist in Florida

Sources for this page

Verify at the official NPI Registry.