Jason Ronald Beall, RN

Individual provider Active NPI Emergency Registered Nurse · Valrico, FL

NPI 1164699682 · NPPES record last updated May 14, 2008

Key facts

NPI
1164699682
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
RN9214696 (FL)
Practice address
4433 Horseshoe Pick LN
Valrico, FL 33594-9304
Phone
(813) 681-7896
NPI assigned
May 14, 2008
Sex
Male
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9214696FLMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN9214696 FL Yes

Addresses

Primary practice location

4433 Horseshoe Pick LN
Valrico, FL 33594-9304

Mailing address

4433 Horseshoe Pick LN
Valrico, FL 33594-9304
Phone (813) 681-7896

Other providers in Valrico, FL

All providers in Valrico, FL · Emergency Registered Nurse in Florida

Sources for this page

Verify at the official NPI Registry.