Susan Carol Beaven, MD
Individual provider Active NPI Family Medicine Physician · Saint Petersburg, FL
NPI 1780908376 · NPPES record last updated Jul 12, 2010
Key facts
- NPI
- 1780908376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- ME42386 (FL)
- Practice address
- 5088 66TH Street North
Saint Petersburg, FL 33709 - Phone
- (727) 541-2675
- Fax
- (727) 541-3956
- NPI assigned
- Mar 25, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Docs Outside the Box | Family Medicine | Past | Accepting new patients |
| Millennium Medical Inc | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME42386 | FL | Yes |
Addresses
Primary practice location
5088 66TH Street North
Saint Petersburg, FL 33709
Mailing address
5088 66TH Street North
Saint Petersburg, FL 33709
Phone (727) 541-2675
Other providers in Saint Petersburg, FL
- Michela Beaulier
- Michele Jeanne Beaulieu
- Lynda M Beaupin
- Beautiful Minds and Harmony Counseling
- Beautiful Transitions, Inc.
- Because You Can, LLC
- Christian Bechtold
- Ashley Beck
- Scott Warren Beck
- Gerhart Becker
All providers in Saint Petersburg, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.