Marieprovi Beauchamp, M.D.
Individual provider Active NPI General Practice Physician · Dorado, PR
NPI 1952532012 · NPPES record last updated Sep 28, 2010
Key facts
- NPI
- 1952532012
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 17677 (PR)
- Practice address
- 75 Calle San Francisco
Dorado, PR 00646-2726 - Phone
- (787) 487-4163
- NPI assigned
- Aug 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130904000068 | PR | Practitioner - General Practice | 2860635208 | Practice locations: Dorado, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 17677 | PR | Yes |
Addresses
Primary practice location
75 Calle San Francisco
Dorado, PR 00646-2726
Mailing address
75 Calle San Francisco
Dorado, PR 00646-2726
Phone (787) 487-4163
Other providers in Dorado, PR
- Dasiel Baez Machado
- Adriana Nicole Baez
- Jaileene E Baez
- Carlos Alberto Barbosa
- Monica Barbosa
- Guillermo Jose Berrios Garcia
- Lisette Maria Berrios Ortiz
- Ingrid Berrios
- Stephanie Berrios
- Best Medical Options LLC
All providers in Dorado, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.