John Derek Beaudry
Individual provider Active NPI Driver · Inverness, FL
NPI 1972056349 · NPPES record last updated Dec 20, 2016
Key facts
- NPI
- 1972056349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 3356 E Gulf to Lake Hwy
Inverness, FL 34453-3230 - Phone
- (352) 419-7081
- NPI assigned
- Aug 2, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oak Transportation, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
3356 E Gulf to Lake Hwy
Inverness, FL 34453-3230
Mailing address
3356 E Gulf to Lake Hwy
Inverness, FL 34453-3230
Phone (352) 419-7081
Other providers in Inverness, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2016. 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.